Provider Demographics
NPI:1861829061
Name:SANTA ANA COLLEGE
Entity Type:Organization
Organization Name:SANTA ANA COLLEGE
Other - Org Name:STUDENT HEALTH AND WELLNESS CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:HARDASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-480-7340
Mailing Address - Street 1:1530 W 17TH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92706-3398
Mailing Address - Country:US
Mailing Address - Phone:714-564-6216
Mailing Address - Fax:
Practice Address - Street 1:1530 W 17TH ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706-3398
Practice Address - Country:US
Practice Address - Phone:714-564-6216
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RANCHO SANTIAGO COMMUNITY COLLEGE DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health