Healthcare Provider Details

I. General information

NPI: 1720700677
Provider Name (Legal Business Name): JANUS OF SANTA CRUZ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2022
Last Update Date: 09/16/2022
Certification Date: 09/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 E BEACH ST
WATSONVILLE CA
95076-4838
US

IV. Provider business mailing address

200 7TH AVE STE 150
SANTA CRUZ CA
95062-4669
US

V. Phone/Fax

Practice location:
  • Phone: 831-462-1060
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code276400000X
TaxonomySubstance Use Disorder Rehabilitation Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: AMBER WILLIAMS
Title or Position: CEO
Credential:
Phone: 831-462-1060