Provider Demographics
NPI:1184785834
Name:COMPREHENSIVE PSYCHIATRIC SERVICES, A MEDICAL GROUP
Entity type:Organization
Organization Name:COMPREHENSIVE PSYCHIATRIC SERVICES, A MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEELA
Authorized Official - Middle Name:
Authorized Official - Last Name:VIRASSAMMY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-944-9711
Mailing Address - Street 1:3100 OAK ROAD
Mailing Address - Street 2:SUITE 270
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-2078
Mailing Address - Country:US
Mailing Address - Phone:925-944-9711
Mailing Address - Fax:925-944-9709
Practice Address - Street 1:3100 OAK ROAD
Practice Address - Street 2:SUITE 270
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94597-2078
Practice Address - Country:US
Practice Address - Phone:925-944-9711
Practice Address - Fax:925-944-9709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1154484749OtherNPI
CA1972666568OtherNPI
CA1982767588OtherNPI
CA1568523306OtherNPI
CA1003977851OtherNPI
CA1215090808OtherNPI
CA1427270248OtherNPI
CA1982767588OtherNPI