Healthcare Provider Details

I. General information

NPI: 1578988747
Provider Name (Legal Business Name): ANKA BEHAVIORAL HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2014
Last Update Date: 10/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 GEORGIA ST
VALLEJO CA
94590-5905
US

IV. Provider business mailing address

1850 GATEWAY BLVD STE 900
CONCORD CA
94520-8418
US

V. Phone/Fax

Practice location:
  • Phone: 925-265-6660
  • Fax:
Mailing address:
  • Phone: 925-825-4700
  • Fax: 925-825-2610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/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