NPIMap

Organization Active NPI

Santa Cruz Community Health Centers

Doing business as Santa Cruz Women's Health Center

  • Family Medicine Physician
  • Santa Cruz, CA
National Provider Identifier
1902923329
Registry record updated Feb 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SANTA CRUZ COMMUNITY HEALTH CENTERS
Doing business as
Santa Cruz Women's Health Center
Practice address
250 Locust St
Santa Cruz, CA 95060-3813
Phone
(831) 427-3500
Fax
(831) 426-3286
NPI assigned
Mar 22, 2007
Last updated
Feb 15, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
SANTA CRUZ COMMUNITY HEALTH CENTERSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 15, 2021

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

Authorized official

Name
Ruth Jasso
Title
Billing Manager
Phone
(831) 427-3500

Specialties & licenses 13

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU
Preferred Provider Organization 305R00000X NU
Physician Assistant 363A00000X NU
Medical Physician Assistant 363AM0700X NU
Nurse Practitioner 363L00000X NU
Perinatal Nurse Practitioner 363LP1700X NU
Women's Health Nurse Practitioner 363LW0102X NU
Mental Health Counselor 101YM0800X NU
Clinical Social Worker 1041C0700X NU
Chiropractor 111N00000X NU
Acupuncturist 171100000X NU
Naturopath 175F00000X NU
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

250 Locust St
Santa Cruz, CA 95060-3813

Mailing address

PO Box 542
Santa Cruz, CA 95061-0542
Phone (831) 427-3500

Other identifiers 1

IdentifierTypeStateIssuer
FHC70078FMedicaidCA

Other names 1

  • Santa Cruz Women's Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041004000763 CA Part B Supplier - Clinic/Group Practice 0840259107 Receives reassigned benefits from 31 practitioners
2 other NPIs on this enrollment
Practice locations: Ben Lomond, CA; Santa Cruz, CA
O20110328000152 CA Part A Provider - Federally Qualified Health Center (FQHC) 0840259107 Practice locations: Santa Cruz, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902923329. Details of each certification follow.

Federally qualified health center certification: CCN 551081

Legal name
SANTA CRUZ COMMUNITY HEALTH CENTERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 28, 2011
Last certification
Mar 28, 2011
Ownership / control type
Non-profit – church related
Organization structure
CorporationNon-profit
Incorporated
Mar 5, 1974 in CA
Enrollment address
250 Locust St
Santa Cruz, CA 95060-3813

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0606624Santa Cruz Women's Health Center250 Locust St, Santa Cruz, CA 95060Provider-performed microscopyFeb 28, 2027

National Provider Directory

National Provider Directory
Part of
Santa Cruz Community Health

Locations

231 Main St
#A
Ben Lomond, CA 95005
Phone (831) 336-1300

250 Locust St
Santa Cruz, CA 95060
Phone (831) 427-3582

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Santa Cruz Community Health Centers Organization, Santa Cruz, CA Corporation, Non-profit Other Jan 1, 2022
William Leland Individual Corporate Director Jan 1, 2022
Joyce Brown Individual Corporate DirectorDirector Jan 1, 2024 100%
Glenys Davidson Individual Corporate DirectorDirector Jan 1, 2024 100%
Andrew Goldenkranz Individual Corporate DirectorDirector Jan 1, 2024 100%
Bianca Crowbear Individual Corporate DirectorDirector Jan 1, 2024 100%
Anita Aguirre Individual Corporate OfficerCeo Jan 8, 2024 100%
W-2 Managing EmployeeCeo Jan 8, 2024 100%
Jorge Savala Individual Corporate Director Jan 1, 2022

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Santa Cruz Community Health CentersSanta Cruz, CA, CCN 751052 Federally qualified health center Other Jan 1, 2022
Santa Cruz Mountain Health Center 2Ben Lomond, CA, CCN A01197 Federally qualified health center Operational/Managerial Control Jan 1, 2023

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 72

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 72

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613347200000",
    "number": "1902923329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 542",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950610542",
            "telephone_number": "831-427-3500",
            "fax_number": "831-426-3286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 LOCUST ST",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950603813",
            "telephone_number": "831-427-3500",
            "fax_number": "831-426-3286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA CRUZ COMMUNITY HEALTH CENTERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SANTA CRUZ COMMUNITY HEALTH CENTERS",
        "enumeration_date": "2007-03-22",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A",
        "authorized_official_last_name": "JASSO",
        "authorized_official_first_name": "RUTH",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "831-427-3500"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP1700X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Perinatal",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC70078F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Santa Cruz Women's Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.