Provider Demographics
NPI:1154515948
Name:COUNTY OF SANTA CRUZ
Entity type:Organization
Organization Name:COUNTY OF SANTA CRUZ
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HEALTH SERVICES AGENCY DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RAMA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHALSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-454-4474
Mailing Address - Street 1:PO BOX 1439
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95061-1439
Mailing Address - Country:US
Mailing Address - Phone:831-454-4730
Mailing Address - Fax:
Practice Address - Street 1:1060 EMELINE AVE
Practice Address - Street 2:BLDG. #F
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-1966
Practice Address - Country:US
Practice Address - Phone:831-454-4730
Practice Address - Fax:831-454-4740
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF SANTA CRUZ
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management