Provider Demographics
NPI:1972214971
Name:COUNTY OF SANTA CLARA
Entity Type:Organization
Organization Name:COUNTY OF SANTA CLARA
Other - Org Name:COUNTY OF SANTA CLARA HEALTH SYSTEM CALAIM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DEPUTY COUNTY EXECUTIVE
Authorized Official - Prefix:
Authorized Official - First Name:RENE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-885-4030
Mailing Address - Street 1:2325 ENBORG LN STE 320
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2649
Mailing Address - Country:US
Mailing Address - Phone:408-885-4030
Mailing Address - Fax:
Practice Address - Street 1:55 OLD TULLY RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95111-1910
Practice Address - Country:US
Practice Address - Phone:408-885-4030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF SANTA CLARA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-12-09
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care