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General NPI Number Information
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NPI Number | 1386948297
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Entity Type | Organization
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Legal Business Name | ANKA BEHAVIORAL HEALTH INC.
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Dates
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Enumeration Date | 01/06/2011
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Last Update Date | 01/06/2011
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Provider Practice Location Address
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Address Line | 5149 WINSTON CT
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City | FREMONT
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State | CA
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Zip | 94536-6523
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Country | US
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Telephone | 510-494-1567
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Fax |
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Provider Business Mailing Address
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Address Line | 1504 DEER CREEK LN
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City | REDWOOD CITY
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State | CA
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Zip | 94062-3253
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Country | US
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Telephone | 650-743-1473
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF CLINICAL TRAINING
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Name | WAYNE THURSTON
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Credential | PSY.D.
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Telephone | 925-825-4700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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