Provider Demographics
NPI:1205214087
Name:NEURO HEALTH, INC
Entity Type:Organization
Organization Name:NEURO HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KATY
Authorized Official - Middle Name:D
Authorized Official - Last Name:GAINES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:323-456-8686
Mailing Address - Street 1:1454 S CREST DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-3312
Mailing Address - Country:US
Mailing Address - Phone:310-490-9899
Mailing Address - Fax:
Practice Address - Street 1:8383 WILSHIRE BLVD
Practice Address - Street 2:SUITE #800
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2425
Practice Address - Country:US
Practice Address - Phone:323-456-8686
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-12
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY26943103G00000X, 103TB0200X, 103TC0700X, 103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensicGroup - Multi-Specialty