Healthcare Provider Details
I. General information
NPI: 1700196961
Provider Name (Legal Business Name): ANKA BEHAVIORAL HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/20/2010
Last Update Date: 07/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5149 WINSTON CT
FREMONT CA
94536
US
IV. Provider business mailing address
3480 BUSKIRK AVE STE 300
PLEASANT HILL CA
94523-4343
US
V. Phone/Fax
- Phone: 510-494-1567
- Fax: 510-494-9768
- Phone: 925-825-4700
- Fax: 925-825-2610
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
NZINGA
HARRISON
Title or Position: CHIEF MEDICAL OFFICER
Credential: MD
Phone: 925-825-4700