Organization
COUNTY OF SANTA CRUZ
Active
Parent organization
COUNTY OF SANTA CRUZ
Other names
Children's Mental Health Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
COUNTY OF SANTA CRUZ
Authorized official
MICHAEL BEATON (HEALTH SERVICES AGENCY DIRECTOR)
(831) 454-4000
Entity
Organization
Contact information
Practice address
1400 EMELINE AVE, 1ST FLOOR, SANTA CRUZ, CA 95060-1976
(831) 454-4900
(831) 454-4663
Mailing address
1400 EMELINE AVE, 1ST FLOOR, SANTA CRUZ, CA 95060-1976
(831) 454-4900
(831) 454-4663
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659315430
LEGAL ENTITY NPI#
CA
05
—
4430
—
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
05/19/2017
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