JANUS OF SANTA CRUZ NPI 1649601550

NPI Information

NPI: 1649601550
Provider Name: JANUS OF SANTA CRUZ

Doing Business As: COMMUNITY CLINIC SOUTH

Classification: Clinic/Center - 261QM2800X
Entity Type: Organization

Specialization: Methadone

Address:
284 PENNSYLVANIA DR STE 1&2
WATSONVILLE, CA
ZIP 95076
Phone: (831) 319-4200
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JANUS OF SANTA CRUZ is a methadone clinic center in Watsonville, CA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. JANUS OF SANTA CRUZ NPI is 1649601550. The provider is registered as an organization entity type.
The provider Is Doing Business As Community Clinic South.

The provider's business location address is:

284 PENNSYLVANIA DR STE 1&2
WATSONVILLE, CA
ZIP 95076-768
Phone: (831) 319-4200
Fax: (831) 319-4204

The provider's authorized official is Amber Williams .
The authorized official title is Chief Executive Officer and has the following contact phone number (831) 278-7906.

The enumeration date for this NPI number is 12/2/2013 and was last updated on 2/23/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251S00000X	Community/Behavioral Health		44-06	CALIFORNIA	No
2	251S00000X	Community/Behavioral Health				No
3	261QM2800X	Clinic/Center	Methadone	4405	CALIFORNIA	No
4	261QM2800X	Clinic/Center	Methadone			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	44AB	MEDICAID	CALIFORNIA
2	44AC	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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