Provider Demographics
NPI:1801267604
Name:FAMILY PSYCHIATRY CENTER INC
Entity type:Organization
Organization Name:FAMILY PSYCHIATRY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALOK
Authorized Official - Middle Name:
Authorized Official - Last Name:BANGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-716-4148
Mailing Address - Street 1:10067 WYATT RANCH WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95829-8003
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8009 BRUCEVILLE RD STE 102
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2332
Practice Address - Country:US
Practice Address - Phone:916-716-4148
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-19
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1313102084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty