Provider Demographics
NPI:1033255070
Name:MOLINA, JOSEFA MARIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSEFA
Middle Name:MARIA
Last Name:MOLINA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1381 UNIVERSITY ST
Mailing Address - Street 2:
Mailing Address - City:HEALDSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:95448-3314
Mailing Address - Country:US
Mailing Address - Phone:707-433-5494
Mailing Address - Fax:707-431-8649
Practice Address - Street 1:1381 UNIVERSITY ST
Practice Address - Street 2:
Practice Address - City:HEALDSBURG
Practice Address - State:CA
Practice Address - Zip Code:95448-3314
Practice Address - Country:US
Practice Address - Phone:707-433-5494
Practice Address - Fax:707-431-8649
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3478103TC0700X
CA21236103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY21236OtherLICENSED PSYCHOLOGIST
CAZZZ91891OtherSANTA CRUZ COUNTY MEDICARE GROUP PTAN#
CAFHC70042FOtherSANTA CRUZ COUNTY MEDI-CAL GROUP PTAN#
CAFHC70044FOtherSANTA CRUZ COUNTY MEDI-CAL GROUP PTAN#
CAPSY21236OtherLICENSED PSYCHOLOGIST