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General NPI Number Information
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NPI Number | 1184785834
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE PSYCHIATRIC SERVICES, A MEDICAL GROUP
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 09/27/2023
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Provider Practice Location Address
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Address Line | 3100 OAK ROAD SUITE 270
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City | WALNUT CREEK
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State | CA
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Zip | 94597-2078
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Country | US
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Telephone | 925-944-9711
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Fax | 925-944-9709
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Provider Business Mailing Address
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Address Line | 3100 OAK ROAD SUITE 270
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City | WALNUT CREEK
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State | CA
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Zip | 94597-2078
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Country | US
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Telephone | 925-944-9711
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Fax | 925-944-9709
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MRS. LEELA VIRASSAMMY
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Credential |
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Telephone | 925-944-9711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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