Provider Demographics
NPI:1629339148
Name:SY, JONATHAN ALABANZA (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:ALABANZA
Last Name:SY
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:2640 BRESLAUER WAY
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-4246
Mailing Address - Country:US
Mailing Address - Phone:530-245-6011
Mailing Address - Fax:
Practice Address - Street 1:2640 BRESLAUER WAY
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-4246
Practice Address - Country:US
Practice Address - Phone:530-245-6011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-31
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-185342084P0800X
ARE-119092084P0800X
AZ574392084P0800X
GA0820182084P0800X
TN585242084P0800X
MO20190046922084P0800X
KY521782084P0800X
LA3121702084P0800X
CODR.00622722084P0800X
NV190132084P0800X
TXS38852084P0800X
CAA1416532084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry