Provider Demographics
NPI:1316735244
Name:NATIONAL PSYCHIATRIC CARE AND REHABILITATION, INC.
Entity type:Organization
Organization Name:NATIONAL PSYCHIATRIC CARE AND REHABILITATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:RUDAKOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-812-2955
Mailing Address - Street 1:2880 ZANKER RD STE 106
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95134-2121
Mailing Address - Country:US
Mailing Address - Phone:415-812-2955
Mailing Address - Fax:408-521-3333
Practice Address - Street 1:268 LEWELLING BLVD
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:CA
Practice Address - Zip Code:94580-1632
Practice Address - Country:US
Practice Address - Phone:415-812-2955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)