Basic Information
| Provider Information | |||||||||
| NPI: | 1386186104 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SANTA CRUZ COUNTY HEALTH SERVICES AGENCY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 701 OCEAN ST | ||||||||
| Address2: | |||||||||
| City: | SANTA CRUZ | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950604003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8314544170 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1400 EMELINE AVE | ||||||||
| Address2: | |||||||||
| City: | SANTA CRUZ | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950601976 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8314544170 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/10/2016 | ||||||||
| LastUpdateDate: | 11/10/2016 | ||||||||
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| AuthorizedOfficialLastName: | BETTS | ||||||||
| AuthorizedOfficialFirstName: | LINDA | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMINISTRATIVE ANALYST | ||||||||
| AuthorizedOfficialTelephone: | 8314544498 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | 95005293 | CA | Y | Agencies | Community/Behavioral Health |
No ID Information.