Provider Demographics
NPI:1619393220
Name:ANKA BEHAVIORAL HEALTH INC.
Entity Type:Organization
Organization Name:ANKA BEHAVIORAL HEALTH INC.
Other - Org Name:ANKA PABLO LANE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:NZINGA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-825-4700
Mailing Address - Street 1:3480 BUSKIRK AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-4343
Mailing Address - Country:US
Mailing Address - Phone:925-825-4700
Mailing Address - Fax:925-825-2610
Practice Address - Street 1:340 PABLO LN
Practice Address - Street 2:
Practice Address - City:NIPOMO
Practice Address - State:CA
Practice Address - Zip Code:93444
Practice Address - Country:US
Practice Address - Phone:805-619-3620
Practice Address - Fax:805-619-7879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-07
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health