Provider Demographics
NPI:1528625209
Name:CALIFORNIA BEHAVIORAL & NURSING PROFESSIONALS PC
Entity type:Organization
Organization Name:CALIFORNIA BEHAVIORAL & NURSING PROFESSIONALS PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GROUP ADMIN
Authorized Official - Prefix:MR
Authorized Official - First Name:EMEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:EKWURU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-281-9003
Mailing Address - Street 1:915 HIGHLAND POINTE DR STE 250
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-5421
Mailing Address - Country:US
Mailing Address - Phone:916-281-9003
Mailing Address - Fax:
Practice Address - Street 1:4112 CRESTLINE AVE
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-7103
Practice Address - Country:US
Practice Address - Phone:916-903-7778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-29
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty