Provider Demographics
NPI:1083875074
Name:COUNTY OF SANTA CLARA
Entity Type:Organization
Organization Name:COUNTY OF SANTA CLARA
Other - Org Name:SCCMHD - URGENT CARE CENTRAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INTERIM BEHAVIORAL HEALTH DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:TERAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-885-5776
Mailing Address - Street 1:828 S BASCOM AVE
Mailing Address - Street 2:#280
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2651
Mailing Address - Country:US
Mailing Address - Phone:408-885-5784
Mailing Address - Fax:
Practice Address - Street 1:2221 ENBORG LN STE 200
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2608
Practice Address - Country:US
Practice Address - Phone:408-885-7855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF SANTA CLARA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-23
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ24372ZMedicare PIN