| Community Clinic North | |
|
1000a & 1010c Emeline Ave Santa Cruz CA 95060 | |
| (831) 425-0112 | |
| (831) 425-1847 |
| Full Name | Community Clinic North |
|---|---|
| Speciality | Clinic/center - Methadone |
| Location | 1000a & 1010c Emeline Ave, Santa Cruz, California |
| Authorized Official Name and Position | Amber Williams (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 8312787906 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Clinic North 200 7th Avenue Suite 150 Santa Cruz CA 95062-4668 Ph: (831) 462-1060 | Community Clinic North 1000a & 1010c Emeline Ave Santa Cruz CA 95060 Ph: (831) 425-0112 |
| NPI Number | 1730213794 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 03/08/2022 |
| Certification Date | 02/23/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730213794 | NPI | - | NPPES |
| 44-05 | Other | CA | DHCS |
| 44AB | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 261QM2800X | Clinic/center - Methadone | 4405 (California) | Primary |
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