| Jose Basaldua, | |
|
2716 Freedom Blvd, Watsonville, CA 95076-1027 | |
| (831) 688-5300 | |
| Not Available |
| Full Name | Jose Basaldua |
|---|---|
| Gender | Male |
| Speciality | Counselor - Mental Health |
| Location | 2716 Freedom Blvd, Watsonville, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588931935 | NPI | - | NPPES |
| ZZZ91892Z | Other | SANTA CRUZ COUNTY MEDICARE GROUP PTAN# |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Entity Name | Oak Street Health Physicians Group Of New Mexico Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134793151 PECOS PAC ID: 4981001096 Enrollment ID: O20210916000169 |
| Mailing Address | Practice Location Address |
|---|---|
| Jose Basaldua, 2716 Freedom Blvd, Watsonville, CA 95076-1027 Ph: () - | Jose Basaldua, 2716 Freedom Blvd, Watsonville, CA 95076-1027 Ph: (831) 688-5300 |
Roberto Zamora, Counselor Medicare: Not Enrolled in Medicare Practice Location: 360 Whiskey Hill Rd, Watsonville, CA 95076 Phone: 831-840-2259 | |
Michael Gong, Counselor Medicare: Not Enrolled in Medicare Practice Location: 335 E Lake Ave, Watsonville, CA 95076 Phone: 831-728-6445 Fax: 831-761-6011 | |
Kristine Hansen, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 411 E Lake Ave, Watsonville, CA 95076 Phone: 831-728-6445 | |
Lizbeth Tapia Cerriteno, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2716 Freedom Blvd, Watsonville, CA 95076 Phone: 831-688-6293 | |
Jane Kim, Counselor Medicare: Not Enrolled in Medicare Practice Location: 335 E Lake Ave, Watsonville, CA 95076 Phone: 831-728-6445 Fax: 831-761-6011 | |
Richard Gonzales, Counselor Medicare: Not Enrolled in Medicare Practice Location: 360 Whiskey Hill Rd, Watsonville, CA 95076 Phone: 831-724-9333 | |
Edgar Ivan Alcaraz, PPS Counselor Medicare: Not Enrolled in Medicare Practice Location: 294 Green Valley Rd, Watsonville, CA 95076 Phone: 831-786-2390 |