Healthcare Provider Details

I. General information

NPI: 1578603247
Provider Name (Legal Business Name): ANKA BEHAVIORAL HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 07/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 S LEWIS RD
CAMARILLO CA
93012
US

IV. Provider business mailing address

3480 BUSKIRK AVE STE 300
PLEASANT HILL CA
94523-4343
US

V. Phone/Fax

Practice location:
  • Phone: 805-765-9050
  • Fax: 805-765-9073
Mailing address:
  • Phone: 925-825-4700
  • Fax: 925-825-2610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number02015028
License Number StateCA

VIII. Authorized Official

Name: DR. NZINGA HARRISON
Title or Position: CHIEF MEDICAL OFFICER
Credential: MD
Phone: 925-825-4700