Provider Demographics
NPI:1689125163
Name:ANKA BEHAVIORAL HEALTH, INC.
Entity Type:Organization
Organization Name:ANKA BEHAVIORAL HEALTH, INC.
Other - Org Name:ANKA WESTON RANCH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF QM
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAHN-SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-689-0311
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:925-082-5470
Mailing Address - Fax:925-825-2610
Practice Address - Street 1:2428 WARLOW LN
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95206
Practice Address - Country:US
Practice Address - Phone:209-689-0311
Practice Address - Fax:209-337-2104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-19
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health