Provider Demographics
NPI:1285033514
Name:COUNTY OF SANTA CRUZ
Entity Type:Organization
Organization Name:COUNTY OF SANTA CRUZ
Other - Org Name:SANTA CRUZ COUNTY HEALTH SERVICES AGENCY
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF OF CLINIC SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:PEELER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-454-4764
Mailing Address - Street 1:1080 EMELINE AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-1966
Mailing Address - Country:US
Mailing Address - Phone:831-454-4764
Mailing Address - Fax:831-454-4893
Practice Address - Street 1:115A CORAL ST
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-2131
Practice Address - Country:US
Practice Address - Phone:831-454-2080
Practice Address - Fax:831-454-3424
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF SANTA CRUZ
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-08-22
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)