Healthcare Provider Details

I. General information

NPI: 1831478064
Provider Name (Legal Business Name): ANKA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2011
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

744 COLUMBIA DR
OXNARD CA
93033-6549
US

IV. Provider business mailing address

744 COLUMBIA DR
OXNARD CA
93033-6549
US

V. Phone/Fax

Practice location:
  • Phone: 805-607-1487
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: EVELYN RUIZ
Title or Position: MHRW
Credential:
Phone: 805-607-1487