Sjt Ventures In PC
Psychiatry & Neurology, Psychiatry in Fort Wayne, IN. Organization (NPI-2).
NPI number1023916004
StatusActive
Last updated in NPPESOct 28, 2026
Details
- NPI
- 1023916004
- Entity type
- Organization (NPI-2)
- Legal business name
- Sjt Ventures In PC
- Organization subpart
- Yes
- Enumeration date
- Oct 28, 2026
- Certification date
- Oct 28, 2026
- Last updated
- Oct 28, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology, Psychiatry | – | – | Yes |
| 103TA0400X | Psychologist, Addiction (Substance Use Disorder) | – | – | |
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – |
Practice location
5534 Saint Joe RdFort Wayne, IN 46835-3328
Phone 949-688-3903
Mailing address
17595 Harvard Ave Ste C3350Irvine, CA 92614-8516
Phone 949-688-3903
Authorized official
Sanjai Thankachen
President
9496883903
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