Provider Demographics
NPI:1932963774
Name:NEUROHEALTH SPECIALISTS, A PSYCHOLOGICAL CORPORATION
Entity Type:Organization
Organization Name:NEUROHEALTH SPECIALISTS, A PSYCHOLOGICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:H
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:562-477-5674
Mailing Address - Street 1:3020 OLD RANCH PKWY STE 328
Mailing Address - Street 2:
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-2751
Mailing Address - Country:US
Mailing Address - Phone:562-477-5674
Mailing Address - Fax:562-800-6105
Practice Address - Street 1:3020 OLD RANCH PKWY STE 328
Practice Address - Street 2:
Practice Address - City:SEAL BEACH
Practice Address - State:CA
Practice Address - Zip Code:90740-2751
Practice Address - Country:US
Practice Address - Phone:562-477-5674
Practice Address - Fax:562-800-6105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty