| Transition Age Youth Program (tay) | |
|
120 Dubois St Santa Cruz CA 95060-2109 | |
| (831) 588-0659 | |
| Not Available |
| Full Name | Transition Age Youth Program (tay) |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 120 Dubois St, Santa Cruz, California |
| Authorized Official Name and Position | Monica Martinez (CEO) |
| Authorized Official Contact | 8314691700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Transition Age Youth Program (tay) 380 Encinal St Ste 200 Santa Cruz CA 95060-2178 Ph: (831) 469-1700 | Transition Age Youth Program (tay) 120 Dubois St Santa Cruz CA 95060-2109 Ph: (831) 588-0659 |
| NPI Number | 1972930097 |
|---|---|
| Provider Enumeration Date | 10/03/2013 |
| Last Update Date | 12/30/2022 |
| Certification Date | 12/30/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972930097 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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