Virtuoso Psychiatry Group

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

A91530 Issued in CA

Legal business name

VIRTUOSO PSYCHIATRY GROUP

Practice address

5040 Woodspring CT
Granite Bay, CA 95746-8838

Phone

(530) 902-7875

Fax

(916) 784-2610

NPI assigned

Nov 2, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Phacharawut J Kanchananakhin, MD

Title

President

Phone

(530) 902-7875

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1446422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446422400000",
    "number": "1922471747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5040 WOODSPRING CT",
            "city": "GRANITE BAY",
            "state": "CA",
            "postal_code": "957468838",
            "telephone_number": "530-902-7875",
            "fax_number": "916-784-2610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5040 WOODSPRING CT",
            "city": "GRANITE BAY",
            "state": "CA",
            "postal_code": "957468838",
            "telephone_number": "530-902-7875",
            "fax_number": "916-784-2610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRTUOSO PSYCHIATRY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-02",
        "last_updated": "2015-11-02",
        "status": "A",
        "authorized_official_last_name": "KANCHANANAKHIN",
        "authorized_official_first_name": "PHACHARAWUT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "530-902-7875",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CA",
            "license": "A91530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Granite Bay, CA
• Providers in Granite Bay, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2015; 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.