Provider Demographics
NPI:1386329142
Name:SANTA CRUZ COMMUNITY HEALTH CENTERS
Entity type:Organization
Organization Name:SANTA CRUZ COMMUNITY HEALTH CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:JASSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-427-3500
Mailing Address - Street 1:PO BOX 542
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95061-0542
Mailing Address - Country:US
Mailing Address - Phone:831-427-3500
Mailing Address - Fax:831-426-3286
Practice Address - Street 1:231 MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:BEN LOMOND
Practice Address - State:CA
Practice Address - Zip Code:95005-9394
Practice Address - Country:US
Practice Address - Phone:831-427-3500
Practice Address - Fax:831-426-3286
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SANTA CRUZ COMMUNITY HEALTH CENTERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center