Provider Demographics
NPI:1750155610
Name:SANTA CRUZ CONCIERGE HEALTH PC
Entity type:Organization
Organization Name:SANTA CRUZ CONCIERGE HEALTH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNARD
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:209-712-1173
Mailing Address - Street 1:740 FRONT ST STE 130
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-4536
Mailing Address - Country:US
Mailing Address - Phone:209-712-1173
Mailing Address - Fax:
Practice Address - Street 1:740 FRONT ST STE 130
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-4536
Practice Address - Country:US
Practice Address - Phone:831-316-3161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-10
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty