Provider Demographics
NPI:1922719343
Name:SANTA CRUZ PSYCHOTHERAPY PC
Entity Type:Organization
Organization Name:SANTA CRUZ PSYCHOTHERAPY PC
Other - Org Name:SANTA CRUZ THERAPY COLLECTIVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:
Authorized Official - Last Name:KALJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-302-2324
Mailing Address - Street 1:PO BOX 4269
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95063-4269
Mailing Address - Country:US
Mailing Address - Phone:831-302-2323
Mailing Address - Fax:
Practice Address - Street 1:830 BAY AVE
Practice Address - Street 2:
Practice Address - City:CAPITOLA
Practice Address - State:CA
Practice Address - Zip Code:95010-2167
Practice Address - Country:US
Practice Address - Phone:831-302-2323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-06
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty