Provider Demographics
NPI:1780040717
Name:KREUTZER, ZORA BERNICE
Entity Type:Individual
Prefix:
First Name:ZORA
Middle Name:BERNICE
Last Name:KREUTZER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ZORA
Other - Middle Name:BERNICE
Other - Last Name:UNDERWOOD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2145 C ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-3711
Mailing Address - Country:US
Mailing Address - Phone:707-601-9994
Mailing Address - Fax:
Practice Address - Street 1:720 WOOD ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-4413
Practice Address - Country:US
Practice Address - Phone:707-268-2990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator