MEDICARE: ANKA HEHAVIORAL HEALTH, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1811313422
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANKA HEHAVIORAL HEALTH, INC.

Provider Business Mailing Address
First Line	:	3480 BUSKIRK AVE STE 300
Second Line	:
City	:	PLEASANT HILL
State	:	CA
Zip	:	94523-4343
Country	:	US
Telephone Number	:	925-825-4700
Fax Number	:	925-825-2610

Provider Business Practice Location Address
First Line	:	3318 W WYOMING AVE
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91505
Country	:	US
Telephone Number	:	925-825-4700
Fax Number	:	925-825-2610

Authorized Official
Title or Position	:	CHIEF MEDICAL OFFICER
Name	:	DR. NZINGA HARRISON
Credential	:	MD
Telephone Number	:	925-825-4700

Provider Enumeration Date	:	03/07/2014
Last Update Date	:	07/03/2018

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