NPIMap

Organization Active NPI

National Psychiatric Care and Rehabilitation Services

  • Psychiatric Residential Treatment Facility
  • Vallejo, CA
National Provider Identifier
1770143042
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
Legal business name
NATIONAL PSYCHIATRIC CARE AND REHABILITATION SERVICES
Practice address
3467 Edgewater PL
Vallejo, CA 94591-8398
Phone
(707) 570-8953
NPI assigned
Jun 18, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Alex Rudakov
Title
President
Phone
(415) 812-2955

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X Primary

Addresses

Primary practice location

3467 Edgewater PL
Vallejo, CA 94591-8398

Mailing address

2880 Zanker Rd Ste 106
San Jose, CA 95134-2121
Phone (415) 812-2955

Other names 1

  • National Vallejo Doing business as

National Provider Directory

National Provider Directory
Tax ID family
National Psychiatric Care and Rehabilitation Services8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560816000000",
    "number": "1770143042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2880 ZANKER RD STE 106",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951342121",
            "telephone_number": "415-812-2955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3467 EDGEWATER PL",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945918398",
            "telephone_number": "707-570-8953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONAL PSYCHIATRIC CARE AND REHABILITATION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-18",
        "last_updated": "2019-06-18",
        "status": "A",
        "authorized_official_last_name": "RUDAKOV",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "415-812-2955"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "National Vallejo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vallejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.