NPI Code Details Logo

NPI 1801201488

NPI 1801201488 : NATIONAL PSYCHIATRIC CARE AND REHABILITATION SERVICES : SAN JOSE, CA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1801201488
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    NATIONAL PSYCHIATRIC CARE AND REHABILITATION SERVICES 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    06/23/2014
-----------------------------------------------------
    Last Update Date     |    06/23/2014
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    4182 CHERRY AVE 
-----------------------------------------------------
    City                 |    SAN JOSE
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    95118-1717
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    408-826-4058
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    2880 ZANKER RD STE 101 
-----------------------------------------------------
    City                 |    SAN JOSE
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    95134-2121
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    415-812-2955
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    MANAGER
-----------------------------------------------------
    Name                 |     ALEX  RUDAKOV 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    415-812-2955
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    323P00000X
-----------------------------------------------------
    Taxonomy Name        |    Psychiatric Residential Treatment Facility
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.