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115a Coral St Santa Cruz CA 95060-2131 | |
| (831) 454-2080 | |
| (831) 454-3424 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 115a Coral St, Santa Cruz, California |
| Authorized Official Name and Position | Amy Peeler (CHIEF OF CLINIC SERVICES) |
| Authorized Official Contact | 8314544764 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1080 Emeline Ave Santa Cruz CA 95060-1966 Ph: (831) 454-4764 | 115a Coral St Santa Cruz CA 95060-2131 Ph: (831) 454-2080 |
| NPI Number | 1285033514 |
|---|---|
| Provider Enumeration Date | 08/22/2014 |
| Last Update Date | 03/04/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285033514 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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