Provider Demographics
NPI:1437936812
Name:COUNTY OF SANTA CLARA
Entity Type:Organization
Organization Name:COUNTY OF SANTA CLARA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER II
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:L
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:669-219-4252
Mailing Address - Street 1:2480 N 1ST ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95131-1014
Mailing Address - Country:US
Mailing Address - Phone:669-219-4252
Mailing Address - Fax:
Practice Address - Street 1:2480 N 1ST ST STE 200
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95131-1014
Practice Address - Country:US
Practice Address - Phone:669-219-4252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization