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General NPI Number Information
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NPI Number | 1629339148
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Entity Type | Individual
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Provider Name | JONATHAN ALABANZA SY M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/31/2012
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Last Update Date | 10/22/2019
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Provider Practice Location Address
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Address Line | 2640 BRESLAUER WAY
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City | REDDING
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State | CA
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Zip | 96001-4246
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Country | US
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Telephone | 530-245-6011
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Fax |
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Provider Business Mailing Address
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Address Line | 2640 BRESLAUER WAY
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City | REDDING
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State | CA
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Zip | 96001-4246
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Country | US
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Telephone | 530-245-6011
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | MD-18534
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License Number State | HI
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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 | E-11909
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 57439
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 082018
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 58524
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License Number State | TN
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Taxonomy #6
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 2019004692
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License Number State | MO
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Taxonomy #7
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 52178
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License Number State | KY
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Taxonomy #8
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 312170
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License Number State | LA
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Taxonomy #9
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | DR.0062272
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License Number State | CO
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Taxonomy #10
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 19013
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License Number State | NV
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Taxonomy #11
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | S3885
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License Number State | TX
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Taxonomy #12
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A141653
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License Number State | CA
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