| South County Mental Health | |
|
1430 Freedom Blvd Suite F Watsonville CA 95076-2780 | |
| (831) 763-8200 | |
| (831) 454-4663 |
| Full Name | South County Mental Health |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 1430 Freedom Blvd, Watsonville, California |
| Authorized Official Name and Position | Jessica Randolph (DIRECTOR OF ADMINISTRATION) |
| Authorized Official Contact | 8314544000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South County Mental Health 1400 Emeline Ave Santa Cruz CA 95060-1976 Ph: (831) 454-4971 | South County Mental Health 1430 Freedom Blvd Suite F Watsonville CA 95076-2780 Ph: (831) 763-8200 |
| NPI Number | 1801930920 |
|---|---|
| Provider Enumeration Date | 02/20/2007 |
| Last Update Date | 10/23/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801930920 | NPI | - | NPPES |
| 1659315430 | Other | CA | LEGAL ENTITY NPI# |
| ZZZ91891Z | Other | CA | COUNTY OF SANTA CRUZ MEDICARE GROUP PTAN# |
| 4475 | Medicaid | CA | |
| FHC70044F | Other | CA | SANTA CRUZ COUNTY MEDI-CAL GROUP NUNMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (California) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (California) | Secondary |
Youth Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 165 Harkins Slough Rd, Watsonville, CA 95076 Phone: 831-688-8856 | |
Tyler House Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2716 Freedom Blvd, Watsonville, CA 95076 Phone: 831-688-6293 | |
Pajaro Valley Prevention And Student Assistance Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 240 E Lake Ave, Watsonville, CA 95076 Phone: 831-728-6300 Fax: 831-761-6011 | |
Pajaro Valley Prevention And Student Assistance Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 335 E Lake Ave, Watsonville, CA 95076 Phone: 831-728-6300 Fax: 831-761-6011 | |
Youth Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 251 E Lake Ave, Watsonville, CA 95076 Phone: 831-429-8350 | |
Youth Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 255 E Lake Ave, Watsonville, CA 95076 Phone: 831-728-2227 Fax: 831-728-3629 | |
Santa Cruz Aba Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 40 Penny Ln, Watsonville, CA 95076 Phone: 831-291-3570 Fax: 844-831-5548 |