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General NPI Number Information
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NPI Number | 1295013787
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Entity Type | Organization
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Legal Business Name | SHIV BEHAVIORAL HEALTH INC
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Dates
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Enumeration Date | 08/01/2011
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Last Update Date | 08/02/2011
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Provider Practice Location Address
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Address Line | 3060 STONEGATE DR
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City | ALAMO
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State | CA
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Zip | 94507-1760
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Country | US
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Telephone | 925-389-3973
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Fax |
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Provider Business Mailing Address
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Address Line | 3060 STONEGATE DR
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City | ALAMO
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State | CA
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Zip | 94507-1760
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Country | US
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Telephone | 925-389-3973
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Fax |
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Authorized Official
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Title or Position | PSYCHIATRIST
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Name | KAMALJEET BOORA
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Credential | MD
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Telephone | 925-389-3973
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A102846
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License Number State | CA
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