JANUS OF SANTA CRUZ (NPI# 1649601550) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1649601550 |
Entity Type | Organization |
Organization Name | JANUS OF SANTA CRUZ |
Other Organization Name | COMMUNITY CLINIC SOUTH |
Practice Address |
284 Pennsylvania Dr. Watsonville CA 95076-3768 |
Mailing Address |
200 7th Avenue Suite 150 Santa Cruz CA 95062-4668 |
Practice Telephone | 8313194200 |
Practice Fax Number | 8313194204 |
Mailing Telephone | 8314621060 |
Mailing Fax Number | 8314624970 |
Enumeration Date | 2013-12-02 |
Last Update Date | 2017-09-27 |
Authorized Official Name | RUDOLPH VINCENT ESCALANTE (CHIEF EXECUTIVE OFFICER) |
Authorized Official Telephone | 8314621060 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 251S00000X | Community/Behavioral Health | 44-06 | CA | Agencies |
Y | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
4405 | CA | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | 44AB | 05 |
Other Name | Type Code |
---|---|
Community Clinic South | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194971473 | Janus of Santa Cruz | Substance Abuse Rehabilitation Facility | 516 Chestnut St., Santa Cruz, CA 95060-3669 | 2008-08-18 |
1730213794 | Janus of Santa Cruz | Clinic/Center | 1000a Emeline Ave, Santa Cruz, CA 95060 | 2007-03-14 |
1578620183 | Janus of Santa Cruz | Substance Abuse Rehabilitation Facility | 200 7th Avenue, Suite 150, Santa Cruz, CA 95062-4668 | 2007-01-02 |
1467608745 | Janus of Santa Cruz | Community/Behavioral Health | 200 7th Avenue, Suite 150, Santa Cruz, CA 95062-4668 | 2008-08-18 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | JANUS OF SANTA CRUZ | 200 7th Ave Ste 150, Santa Cruz, CA 95062-4669 |
Street Address |
284 PENNSYLVANIA DR. |
City | WATSONVILLE |
State | CA |
Zip Code | 95076-3768 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841757515 | Vicky E Gonzalez | Case Manager/Care Coordinator | 2714 Freedom Blvrd, Watsonville, CA 95076 | 2019-02-28 |
1861987059 | Encompass Community Services | Community/Behavioral Health | 2714 Freedom Blvd., Freedom, CA 95076 | 2018-06-29 |
1134617798 | Haven of Hope, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 107 Pauline Dr, Watsonville, CA 95076 | 2018-04-28 |
1346743911 | Kathleen Long | Physician Assistant | 2468, 75 Nielson St, Watsonville, CA 95076 | 2018-03-09 |
1811403603 | Hieu Thi Thanh Nguyen Boulom | Pharmacist | 2810 Freedom Blvd, Watsonview, CA 95076 | 2017-12-16 |
1649798398 | Jonathon Rank | Counselor | 335 East Lake Ave, Watsonville, CA 95076 | 2017-09-01 |
1841653318 | Cristina Guzman | Registered Nurse | 195 Aviation Way, Ste 200, Watsonville, CA 95076 | 2016-04-01 |
1013388974 | Salud Para La Gente | Clinic/Center | 195 Aviation Way, Suite 200, Watsonville, CA 95076 | 2015-10-16 |
1386025757 | Yaseer Yousuf Parupia | Podiatrist | 47 Penny Lane, Suite 1, Watsonville, CA 95076 | 2015-06-11 |
1093100935 | Diana Perezchica | Counselor | 20716 Freedom Blv, Watsonville, CA 95076 | 2015-03-30 |
Find all providers in zip 95076 |
Taxonomy Code | 261QM2800X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Methadone Clinic |
An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |
Notes: [7/1/2003: new] |
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1083141600 | Baart Behavioral Health Services, Inc. | Clinic/Center | 1145 Market St Fl 10, San Francisco, CA 94103-1566 | 2017-05-13 |
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City | WATSONVILLE |
Zip Code | 95076 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.