County of Santa Cruz

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

04130F Issued in CA

Legal business name

COUNTY OF SANTA CRUZ

Practice address

1430 Freedom Blvd
Laboratory
Watsonville, CA 95076-2780

Phone

(831) 763-8173

Fax

(831) 763-8237

NPI assigned

Feb 6, 2007

Organization subpart

Yes

Parent organization

THE COUNTY OF SANTA CRUZAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Amy Peeler

Title

Chief of Clinics

Phone

(831) 454-4764

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Health Services Agency Watsonville Health Center Laboratory Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• County of Santa Cruz

  • Clinical Medical Laboratory
  • Santa Cruz, CA
  • NPI 1740329515

  O20080502000340

  Same enrollment
• County of Santa Cruz

  dba Watsonville Health Center

  • Federally Qualified Health Center (FQHC)
  • Watsonville, CA
  • NPI 1770709149

  O20080502000340

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Santa Cruz County

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701129600000",
    "number": "1063551976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 FREEDOM BLVD",
            "address_2": "LABORATORY",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950762780",
            "telephone_number": "831-763-8173",
            "fax_number": "831-763-8237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 FREEDOM BLVD",
            "address_2": "LABORATORY",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950762780",
            "telephone_number": "831-763-8173",
            "fax_number": "831-763-8237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF SANTA CRUZ",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE COUNTY OF SANTA CRUZ",
        "enumeration_date": "2007-02-06",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A",
        "authorized_official_last_name": "PEELER",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CHIEF OF CLINICS",
        "authorized_official_telephone_number": "831-454-4764",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "04130F",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMS CLIA",
            "identifier": "05D0875212",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA. FAMILY PLANNING",
            "identifier": "HAP70044F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LAB04130F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "ZZZ95051Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "BQ985",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CA154566",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Health Services Agency Watsonville Health Center Laboratory",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Health Services Agency Watsonville Health Center Laboratory",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Rachel Cookerly
• Karina Elizabeth Cordero
• Sandra Cordova
• Abel Corona
• Blanca Estella Corrales
• County of Santa Cruz (Watsonville Health Center)
• Court Appointed Special Advocates (Casa) of Santa Cruz County
• Rachael Cox
• Brian Criswell
• Douglas Crocker

• Clinical Medical Laboratory in Watsonville, CA
• Providers in Watsonville, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.