Organization
COUNTY OF SANTA CRUZ
Active
Parent organization
COUNTY OF SANTA CRUZ
Other names
County of Santa Cruz Health Services Agency FQHC Santa Cruz Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
COUNTY OF SANTA CRUZ
Authorized official
AMY PEELER (CHIEF OF CLINICS)
(831) 454-4764
Entity
Organization
Contact information
Practice address
1080 EMELINE AVE, SANTA CRUZ, CA 95060-1966
(831) 454-4100
(831) 454-4296
Mailing address
1080 EMELINE AVE, SANTA CRUZ, CA 95060-1966
(831) 454-4100
(831) 454-4488
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
CA
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659315430
LEGAL ENTITY NPI
CA
01
—
BCP70042F
CANCER DETECTION PROGRM
CA
05
—
FHC70042F
—
CA
01
—
HAP70042F
STATE - FAMILY PLANNING
CA
Enumeration date
03/26/2007
Last updated
11/28/2023
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