| Family Service Agency Of The Central Coast | |
|
104 Walnut Ave Suite 208 Santa Cruz CA 95060-3900 | |
| (831) 423-9444 | |
| (831) 423-9444 |
| Full Name | Family Service Agency Of The Central Coast |
|---|---|
| Speciality | Counselor |
| Location | 104 Walnut Ave, Santa Cruz, California |
| Authorized Official Name and Position | David Arthur Bianchi (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8314239444 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Service Agency Of The Central Coast 104 Walnut Ave Suite 208 Santa Cruz CA 95060-3900 Ph: () - | Family Service Agency Of The Central Coast 104 Walnut Ave Suite 208 Santa Cruz CA 95060-3900 Ph: (831) 423-9444 |
| NPI Number | 1104994136 |
|---|---|
| Provider Enumeration Date | 11/30/2006 |
| Last Update Date | 05/09/2018 |
| Medicare PECOS PAC ID | 1052213527 |
|---|---|
| Medicare Enrollment ID | O20040123001089 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104994136 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 103T00000X | Psychologist | (California) | Secondary |
| 104100000X | Social Worker | (California) | Secondary |
| Provider Name | David Ross Johnston |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346308491 PECOS PAC ID: 8820989049 Enrollment ID: I20040324001202 |
| Provider Name | Julie Goldberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942390877 PECOS PAC ID: 2769438936 Enrollment ID: I20050330000998 |
| Provider Name | Lance P Cowan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780880369 PECOS PAC ID: 9133261910 Enrollment ID: I20100115000656 |
| Provider Name | Joan Donato |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669482444 PECOS PAC ID: 7810029931 Enrollment ID: I20100724000040 |
| Provider Name | Carol E Cowen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972804383 PECOS PAC ID: 5597945378 Enrollment ID: I20110210001137 |
| Provider Name | Robert L Bartee |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942331541 PECOS PAC ID: 3971770868 Enrollment ID: I20120216000380 |
| Provider Name | Sanda J Spiegel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184862906 PECOS PAC ID: 4284866963 Enrollment ID: I20140411000063 |
| Provider Name | Sheri M Anselmi |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144353640 PECOS PAC ID: 0749403541 Enrollment ID: I20140523001361 |
| Provider Name | Amy I Gregg |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578762407 PECOS PAC ID: 3779803127 Enrollment ID: I20150526002169 |
| Provider Name | Oscar Torres |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083157481 PECOS PAC ID: 2466734256 Enrollment ID: I20170201000425 |
| Provider Name | Rebecca B Cope |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770708018 PECOS PAC ID: 2860650421 Enrollment ID: I20170217002150 |
| Provider Name | Jodie D Ross-mordaunt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528555919 PECOS PAC ID: 9931464963 Enrollment ID: I20180522003002 |
| Provider Name | Leslie H Hoffman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679095202 PECOS PAC ID: 7911309794 Enrollment ID: I20210715004013 |
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Family Service Agency Of The Central Coast Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 104 Walnut Ave, Ste 208, Santa Cruz, CA 95060 Phone: 831-423-9444 Fax: 831-423-1532 | |
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