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General NPI Number Information
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NPI Number | 1497137400
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Entity Type | Organization
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Legal Business Name | ANKA BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 06/25/2015
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Last Update Date | 06/25/2015
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Provider Practice Location Address
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Address Line | 610 DEVONSHIRE LOOP
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City | BRENTWOOD
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State | CA
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Zip | 94513-2619
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Country | US
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Telephone | 925-698-5328
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1173
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City | OAKLEY
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State | CA
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Zip | 94561-1173
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Country | US
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Telephone | 925-698-5328
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Fax |
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Authorized Official
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Title or Position | SENIOR QM MANAGER
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Name | GINA M VYROSTEK
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Credential |
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Telephone | 925-270-2101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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