Organization
COUNTY OF SANTA CRUZ
Active
Parent organization
COUNTY OF SANTA CRUZ
Other names
North County Mental Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
COUNTY OF SANTA CRUZ
Authorized official
JESSICA RANDOLPH (DIRECTOR OF ADMINISTRATION)
(831) 454-4000
Entity
Organization
Contact information
Practice address
1400 EMELINE AVE, 2ND FLOOR, SANTA CRUZ, CA 95060-1976
(831) 454-4170
(831) 454-4663
Mailing address
1400 EMELINE AVE, SANTA CRUZ, CA 95060-1976
(831) 454-4170
(831) 454-4663
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659315430
SANTA CRUZ COUNTY CLINIC-CENTER LEGAL ORG NPI#
CA
05
—
4416
—
CA
01
—
FHC70042F
SANTA CRUZ COUNTY MEDI-CAL GROUP#
CA
01
—
ZZZ92069Z
SANTA CRUZ COUNTY MEDICARE GROUP PTAN#
CA
Enumeration date
02/20/2007
Last updated
10/25/2019
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