NPIMap

Organization Active NPI

Community Bridges

  • Community Health Worker
  • Watsonville, CA
National Provider Identifier
1982397014
Registry record updated Jun 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Legal business name
COMMUNITY BRIDGES
Practice address
519 Main Street
Suite Y
Watsonville, CA 95076-4356
Phone
(831) 724-2997
Fax
(831) 724-2915
NPI assigned
Jun 2, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2023

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

Authorized official

Name
Mr. Raymon Cancino
Title
Chief Executive Officer
Phone
(831) 688-8840

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 172V00000X Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

519 Main Street
Suite Y
Watsonville, CA 95076-4356

Mailing address

519 Main Street
Watsonville, CA 95076-4356
Phone (831) 688-8840

National Provider Directory

National Provider Directory
Tax ID family
Community Bridges7 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

519 Main St
Ste Y
Watsonville, CA 95076
Phone (831) 724-2997

NPI Registry JSON

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

{
    "created_epoch": "1685664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685664000000",
    "number": "1982397014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 MAIN STREET",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950764356",
            "telephone_number": "831-688-8840",
            "fax_number": "831-688-8302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 MAIN STREET",
            "address_2": "SUITE Y",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950764356",
            "telephone_number": "831-724-2997",
            "fax_number": "831-724-2915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY BRIDGES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-02",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A",
        "authorized_official_last_name": "CANCINO",
        "authorized_official_first_name": "RAYMON",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "831-688-8840",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 2, 2023; 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.