# ANTEDAR PSYCHIATRIC NURSING PROFESSIONAL SERVICES, INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871362186
- **Authorized official:** BARIASA KANABOLO NP (CEO)
- **Authorized official phone:** (951) 236-9430

## Contact information

- **Practice address:** 6860 BROCKTON AVE, RIVERSIDE, CA 92506-3821
- **Practice address phone:** (951) 236-9430
- **Mailing address:** PO BOX 51927, RIVERSIDE, CA 92517-2927
- **Mailing address phone:** (951) 236-9430

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 12/28/2023
- **Last updated:** 12/29/2023