| Health Services Agency-fqhc-mental Health | |
|
1080 Emeline Ave Santa Cruz CA 95060-1966 | |
| (831) 454-4000 | |
| Not Available |
| Full Name | Health Services Agency-fqhc-mental Health |
|---|---|
| Speciality | Clinic/center |
| Location | 1080 Emeline Ave, Santa Cruz, California |
| Authorized Official Name and Position | Giang Nguyen (DIRECTOR OF HEALTH SERVICES AGENCY) |
| Authorized Official Contact | 8314544000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Health Services Agency-fqhc-mental Health 1080 Emeline Ave Santa Cruz CA 95060-1966 Ph: (831) 454-4000 | Health Services Agency-fqhc-mental Health 1080 Emeline Ave Santa Cruz CA 95060-1966 Ph: (831) 454-4000 |
| NPI Number | 1659810513 |
|---|---|
| Provider Enumeration Date | 02/13/2017 |
| Last Update Date | 02/13/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659810513 | NPI | - | NPPES |
| 1659315430 | Other | CA | LEGAL ENTITY NUMBER |
| ZZZ91892Z | Other | CA | SANTA CRUZ COUNTY, CA MEDICARE GROUP PTAN# |
| FHC70042F | Other | CA | SANTA CRUZ COUNTY, CA MEDI-CAL GROUP ID# |
| FHC70044F | Other | CA | SANTA CRUZ COUNTY, CA MEDI-CAL GROUP ID# |
| ZZZ92069Z | Other | CA | SANTA CRUZ COUNTY, CA MEDICARE GROUP PTAN# |
| ZZZ91891Z | Other | CA | SANTA CRUZ COUNTY, CA MEDICARE GROUP PTAN# |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (California) | Primary |
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