Healthcare Provider Details
I. General information
NPI: 1063926731
Provider Name (Legal Business Name): PSYCHIATRIC CARE FOR SENIORS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/16/2017
Last Update Date: 11/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
110 LA CASA VIA STE 205
WALNUT CREEK CA
94598-3017
US
IV. Provider business mailing address
4101 DUBLIN BLVD STE F
DUBLIN CA
94568-4603
US
V. Phone/Fax
- Phone: 925-291-7295
- Fax: 866-284-3572
- Phone: 925-451-8599
- Fax: 866-284-3572
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0805X |
| Taxonomy | Geriatric Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KULWINDER
SINGH
Title or Position: PRESIDENT
Credential: MD
Phone: 925-291-7295