Provider Demographics
NPI:1538744297
Name:NEW JERSEY BEHAVIORAL HEALTH P.C
Entity type:Organization
Organization Name:NEW JERSEY BEHAVIORAL HEALTH P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF LEGAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-279-8515
Mailing Address - Street 1:2970 CAMINO DIABLO
Mailing Address - Street 2:FLR 3
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597
Mailing Address - Country:US
Mailing Address - Phone:425-892-6421
Mailing Address - Fax:
Practice Address - Street 1:231 CLARKSVILLE RD STE 4A
Practice Address - Street 2:
Practice Address - City:PRINCETON JUNCTION
Practice Address - State:NJ
Practice Address - Zip Code:08550-5300
Practice Address - Country:US
Practice Address - Phone:732-982-2888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-15
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty