NPIMap

Organization Active NPI

Janus of Santa Cruz

Doing business as Community Clinic North

  • Methadone Clinic
  • Santa Cruz, CA
National Provider Identifier
1730213794
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
License
4405 Issued in CA
Legal business name
JANUS OF SANTA CRUZ
Doing business as
Community Clinic North
Practice address
1000A & 1010C Emeline Ave
Santa Cruz, CA 95060
Phone
(831) 425-0112
Fax
(831) 425-1847
NPI assigned
Mar 14, 2007
Last updated
Mar 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 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 2

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

Addresses

Primary practice location

1000A & 1010C Emeline Ave
Santa Cruz, CA 95060

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
44-05OtherCADHCS
44ABMedicaidCA

Other names 1

  • Community Clinic North Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200130003075 CA Part B Supplier - Opioid Treatment Program (Otp) 6608202171 1 other NPI on this enrollment
This NPI is an additional NPI on the 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

1000A Emeline Ave
Santa Cruz, CA 95060
Phone (831) 425-0112

Practitioners & affiliated clinicians

Practitioners 64

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.

View all 64

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646697600000",
    "number": "1730213794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 7TH AVENUE 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": "1000A & 1010C EMELINE AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "95060",
            "telephone_number": "831-425-0112",
            "fax_number": "831-425-1847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JANUS OF SANTA CRUZ",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2022-03-08",
        "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": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "CA",
            "license": "4405",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHCS",
            "identifier": "44-05",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44AB",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Clinic North",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Community Clinic North",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Cruz, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.