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Fee-for-service Lcsw
Adult Mental Health Clinic/Center in Santa Cruz, California
NPI 1093914483

Fee-for-service Lcsw is an Adult Mental Health Clinic/Center based in Santa Cruz, CA and is specialized in Adult Mental Health. Fee-for-service Lcsw practices in Santa Cruz, CA. The NPI Number for Fee-for-service Lcsw is 1093914483 and holds a License No. (California).

The current practice location address for Fee-for-service Lcsw is 1400 Emeline Ave, Santa Cruz, CA and can be reached out via phone at 831-454-4170 and via fax at 831-454-4663.

Location: 1400 Emeline Ave, Santa Cruz, CA, 95060-1976
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1093914483
Provider Name
Fee-for-service Lcsw
Credential
Provider Entity Type
Organization
Address
1400 Emeline Ave, Santa Cruz, CA, 95060-1976
Phone Number
831-454-4170
Fax Number
831-454-4663
Provider Enumeration Date
07/16/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
44A8 05 CA MEDI-CAL #
1659315430 01 CA LEGAL ENTITY NPI#
institution
Provider Business Practice Location Address Details
Address
1400 Emeline Ave
City
Santa Cruz
State
California
Zip
95060-1976
Phone Number
831-454-4170
Fax Number
831-454-4663
person
Provider Business Mailing Address Details
Address
1400 Emeline Ave
City
Santa Cruz
State
California
Zip
95060-1976
Phone Number
831-454-4170
Fax Number
831-454-4663
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adult Mental Health
Taxonomy
261QM0850X
License No.
(California)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
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