Organization
COUNTY OF SANTA CRUZ
Active
Organization
COUNTY OF SANTA CRUZ
Active
Other names
Health Services Agency-FQHC-Mental Health
Organization subpart
No
Provider details
NPI number
Authorized official
GIANG NGUYEN (DIRECTOR OF HEALTH SERVICES AGENCY)
(831) 454-4000
Entity
Organization
Contact information
Practice address
1080 EMELINE AVE, SANTA CRUZ, CA 95060-1966
(831) 454-4000
Mailing address
1080 EMELINE AVE, SANTA CRUZ, CA 95060-1966
(831) 454-4000
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659315430
LEGAL ENTITY NUMBER
CA
01
—
FHC70042F
SANTA CRUZ COUNTY, CA MEDI-CAL GROUP ID#
CA
01
—
FHC70044F
SANTA CRUZ COUNTY, CA MEDI-CAL GROUP ID#
CA
01
—
ZZZ91891Z
SANTA CRUZ COUNTY, CA MEDICARE GROUP PTAN#
CA
01
—
ZZZ91892Z
SANTA CRUZ COUNTY, CA MEDICARE GROUP PTAN#
CA
01
—
ZZZ92069Z
SANTA CRUZ COUNTY, CA MEDICARE GROUP PTAN#
CA
Enumeration date
02/13/2017
Last updated
02/13/2017
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