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General NPI Number Information
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NPI Number | 1659060960
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Entity Type | Organization
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Legal Business Name | SADANG PSYCHIATRIC SERVICES
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Dates
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Enumeration Date | 05/03/2023
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Last Update Date | 07/30/2023
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Provider Practice Location Address
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Address Line | 1200 147TH AVE
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City | SAN LEANDRO
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State | CA
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Zip | 94578-3423
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Country | US
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Telephone | 415-417-1588
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 147TH AVE
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City | SAN LEANDRO
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State | CA
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Zip | 94578-3423
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Country | US
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Telephone | 415-690-0630
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR/OWNER
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Name | AURELIO EDWARD SADANG
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Credential | RN, NP-C, PMNHNP-BC
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Telephone | 415-690-0630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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