Provider Demographics
NPI:1750841003
Name:WEST NEUROBEHAVIORAL SERVICES NEUROPSYCHOLOGICAL AND PSYCHOLOGICAL CON
Entity Type:Organization
Organization Name:WEST NEUROBEHAVIORAL SERVICES NEUROPSYCHOLOGICAL AND PSYCHOLOGICAL CON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:RADMILA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:858-761-4103
Mailing Address - Street 1:16870 W BERNARDO DR STE 400
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-1678
Mailing Address - Country:US
Mailing Address - Phone:858-761-4103
Mailing Address - Fax:858-683-1478
Practice Address - Street 1:16870 W BERNARDO DR STE 400
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-1678
Practice Address - Country:US
Practice Address - Phone:858-761-4103
Practice Address - Fax:858-683-1478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-22
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty