Provider Demographics
NPI:1114263803
Name:BANKAS, JOHN KWAMENA (IMFT)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:KWAMENA
Last Name:BANKAS
Suffix:
Gender:M
Credentials:IMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9837 FOLSOM BLVD STE F
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-1356
Mailing Address - Country:US
Mailing Address - Phone:916-450-2600
Mailing Address - Fax:916-858-5708
Practice Address - Street 1:9837 FOLSOM BLVD., STE. F
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827
Practice Address - Country:US
Practice Address - Phone:916-450-2600
Practice Address - Fax:916-858-5708
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-27
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMFT82688106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist