NPIMap

Organization Active NPI

Family Service Agency of the Central Coast

Doing business as Survivors Healing Center

  • Mental Health Counselor
  • Santa Cruz, CA
National Provider Identifier
1992115091
Registry record updated Apr 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
FAMILY SERVICE AGENCY OF THE CENTRAL COAST
Doing business as
Survivors Healing Center
Practice address
104 Walnut Ave
Suite 204
Santa Cruz, CA 95060-3929
Phone
(831) 423-9444
Fax
(831) 423-1532
NPI assigned
Apr 29, 2014
Last updated
Apr 29, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
FAMILY SERVICE AGENCY OF THE CENTRAL COASTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 29, 2014

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

Authorized official

Name
David A. Bianchi
Title
Executive Director
Phone
(831) 423-9444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CA Primary

Addresses

Primary practice location

104 Walnut Ave
Suite 204
Santa Cruz, CA 95060-3929

Mailing address

104 Walnut Ave
Suite 204
Santa Cruz, CA 95060-3929
Phone (831) 423-9444

Other identifiers 1

IdentifierTypeStateIssuer
45554OtherCACOUNSELING

Other names 1

  • Survivors Healing Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Family Service Agency9 organizations share this tax ID, including this one
Part of
Family Service Agency

Other organizations with this tax ID 8

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

Locations

104 Walnut Ave
Ste 204
Santa Cruz, CA 95060

NPI Registry JSON

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

{
    "created_epoch": "1398729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398729600000",
    "number": "1992115091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 WALNUT AVE",
            "address_2": "SUITE 204",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950603929",
            "telephone_number": "831-423-9444",
            "fax_number": "831-423-1532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 WALNUT AVE",
            "address_2": "SUITE 204",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950603929",
            "telephone_number": "831-423-9444",
            "fax_number": "831-423-1532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY SERVICE AGENCY OF THE CENTRAL COAST",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAMILY SERVICE AGENCY OF THE CENTRAL COAST",
        "enumeration_date": "2014-04-29",
        "last_updated": "2014-04-29",
        "status": "A",
        "authorized_official_last_name": "BIANCHI",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "831-423-9444"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COUNSELING",
            "identifier": "45554",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Survivors Healing Center",
            "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 Apr 29, 2014; 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.