Healthcare Provider Details

I. General information

NPI: 1316735244
Provider Name (Legal Business Name): NATIONAL PSYCHIATRIC CARE AND REHABILITATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2025
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

268 LEWELLING BLVD
SAN LORENZO CA
94580-1632
US

IV. Provider business mailing address

2880 ZANKER RD STE 106
SAN JOSE CA
95134-2121
US

V. Phone/Fax

Practice location:
  • Phone: 510-363-0206
  • Fax:
Mailing address:
  • Phone: 415-812-2955
  • Fax: 408-521-3333

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: ALEX RUDAKOV
Title or Position: SECRETARY
Credential:
Phone: 415-812-2955