NPIMap

Organization Active NPI

Janus of Santa Cruz

Doing business as Community Clinic South

  • Methadone Clinic
  • Watsonville, CA
National Provider Identifier
1649601550
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
JANUS OF SANTA CRUZ
Doing business as
Community Clinic South
Practice address
284 Pennsylvania Dr Ste 1&2
Watsonville, CA 95076-3768
Phone
(831) 319-4200
Fax
(831) 319-4204
NPI assigned
Dec 2, 2013
Last updated
Feb 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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

Authorized official

Name
Amber WilliamsNPI 1215289533
Title
Chief Executive Officer
Phone
(831) 278-7906

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 44-06 CA
Community/Behavioral Health Agency 251S00000X
Methadone Clinic 261QM2800X 4405 CA
Methadone Clinic 261QM2800X Primary

Addresses

Primary practice location

284 Pennsylvania Dr Ste 1&2
Watsonville, CA 95076-3768

Mailing address

200 7TH Avenue
Suite 150
Santa Cruz, CA 95062-4668
Phone (831) 462-1060

Other names 1

  • Community Clinic South Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200130003075 CA Part B Supplier - Opioid Treatment Program (Otp) 6608202171 1 other NPI on this enrollment
Practice locations: Santa Cruz, CA; Watsonville, CA

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Janus of Santa Cruz7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

284 Pennsylvania Dr
Watsonville, CA 95076
Phone (831) 319-4200

284 Pennsylvania Dr
Ste 12
Watsonville, CA 95076
Phone (831) 319-4200

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1385942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645574400000",
    "number": "1649601550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 7TH AVENUE",
            "address_2": "SUITE 150",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950624668",
            "telephone_number": "831-462-1060",
            "fax_number": "831-462-4970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "284 PENNSYLVANIA DR STE 1&2",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950763768",
            "telephone_number": "831-319-4200",
            "fax_number": "831-319-4204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JANUS OF SANTA CRUZ",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-02",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "831-278-7906"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "44-06",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "CA",
            "license": "4405",
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Clinic South",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Community Clinic South",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Watsonville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.