Provider Demographics
NPI:1134639859
Name:ASPIRE NEURO PSYCHOLOGICAL SERVICES, INC.
Entity Type:Organization
Organization Name:ASPIRE NEURO PSYCHOLOGICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KEIKO
Authorized Official - Middle Name:Y
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:925-885-6070
Mailing Address - Street 1:802 MORNINGSIDE WAY
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-2467
Mailing Address - Country:US
Mailing Address - Phone:925-885-6070
Mailing Address - Fax:
Practice Address - Street 1:2815 MITCHELL DR STE 119
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-1622
Practice Address - Country:US
Practice Address - Phone:925-885-6070
Practice Address - Fax:925-835-7071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-08
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28008103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty