Healthcare Provider Details

I. General information

NPI: 1467551200
Provider Name (Legal Business Name): SUNNY HILLS BEHAVIORAL HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 04/22/2023
Certification Date: 05/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 E. COMMONWEALTH AVE. SUITE 101
FULLERTON CA
92832-3616
US

IV. Provider business mailing address

140 E. COMMONWEALTH AVE. SUITE 101
FULLERTON CA
92832-3616
US

V. Phone/Fax

Practice location:
  • Phone: 714-773-4111
  • Fax: 714-773-4222
Mailing address:
  • Phone: 714-773-4111
  • Fax: 714-773-4222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA46239
License Number StateCA

VIII. Authorized Official

Name: SANDHYA R GUDAPATI
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 714-773-4111