Organization Active NPI

OB-GYN Associates of Santa Cruz

  • Obstetrics & Gynecology Physician
  • Aptos, CA
National Provider Identifier
1194850503
Registry record updated Mar 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A64380 Issued in CA
Legal business name
OB-GYN ASSOCIATES OF SANTA CRUZ
Practice address
7960B Soquel Dr # 401
Aptos, CA 95003-3916
Phone
(831) 479-4966
Fax
(831) 479-4967
NPI assigned
Feb 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2009

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

Authorized official

Name
Dr. Janna Lyn Doherty, MD
Title
President
Phone
(831) 479-4966

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X A64380 CA Primary

Addresses

Primary practice location

7960B Soquel Dr # 401
Aptos, CA 95003-3916

Mailing address

1779 Dominican Way
Santa Cruz, CA 95065-1526
Phone (831) 479-4966

Other identifiers 1

IdentifierTypeStateIssuer
GR0098130MedicaidCA

National Provider Directory

National Provider Directory

Locations

7960 Soquel Dr
#401
Aptos, CA 95003
Phone (831) 479-4966

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238198400000",
    "number": "1194850503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1779 DOMINICAN WAY",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651526",
            "telephone_number": "831-479-4966",
            "fax_number": "831-479-4967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7960B SOQUEL DR # 401",
            "city": "APTOS",
            "state": "CA",
            "postal_code": "950033916",
            "telephone_number": "831-479-4966",
            "fax_number": "831-479-4967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OB-GYN ASSOCIATES OF SANTA CRUZ",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2009-03-28",
        "status": "A",
        "authorized_official_last_name": "DOHERTY",
        "authorized_official_first_name": "JANNA",
        "authorized_official_middle_name": "LYN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "831-479-4966",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A64380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0098130",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aptos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.