Provider Demographics
NPI:1003145293
Name:NEURO-PSYCH ALLIANCE, INC.
Entity Type:Organization
Organization Name:NEURO-PSYCH ALLIANCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:HUGHEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-469-1989
Mailing Address - Street 1:7901 STONERIDGE DRIVE,
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588
Mailing Address - Country:US
Mailing Address - Phone:925-469-1989
Mailing Address - Fax:925-426-2328
Practice Address - Street 1:7901 STONERIDGE DR STE 521
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-4531
Practice Address - Country:US
Practice Address - Phone:925-469-1989
Practice Address - Fax:925-426-2328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-17
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY13703103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty