| Side-by-side | |
|
225 Westridge Dr Watsonville CA 95076-4168 | |
| (831) 724-3885 | |
| Not Available |
| Full Name | Side-by-side |
|---|---|
| Speciality | Counselor |
| Location | 225 Westridge Dr, Watsonville, California |
| Authorized Official Name and Position | Monica Martinez (PROGRAM MANAGER) |
| Authorized Official Contact | 8314691700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Side-by-side 225 Westridge Dr Watsonville CA 95076-4168 Ph: (831) 724-3885 | Side-by-side 225 Westridge Dr Watsonville CA 95076-4168 Ph: (831) 724-3885 |
| NPI Number | 1457474108 |
|---|---|
| Provider Enumeration Date | 04/09/2007 |
| Last Update Date | 02/25/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457474108 | NPI | - | NPPES |
| 44CJ | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| 252Y00000X | Early Intervention Provider Agency | (* (Not Available)) | Secondary |
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