AGOURA NEUROFEEDBACK (NPI# 1457694747) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457694747 |
| Entity Type | Organization |
| Organization Name | AGOURA NEUROFEEDBACK |
| Practice Address |
28720 Roadside Dr Suites 200 Agoura Hills CA 91301-3316 |
| Mailing Address |
28720 Roadside Dr Suite 200 Agoura Hills CA 91301-3316 |
| Practice Telephone | 6267979977 |
| Practice Fax Number | 6268442977 |
| Mailing Telephone | 6267979977 |
| Mailing Fax Number | 6268442977 |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2015-12-03 |
| Authorized Official Name | SHARI CORBITT (CEO) |
| Authorized Official Telephone | 6267979977 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
Behavioral Health & Social Service Providers | ||
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083238968 | Agoura Neurofeedback | Substance Abuse Rehabilitation Facility | 5490 Fairview Pl, Agoura Hills, CA 91301-2224 | 2020-06-05 |
| Street Address |
28720 ROADSIDE DR SUITES 200 |
| City | AGOURA HILLS |
| State | CA |
| Zip Code | 91301-3316 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720033707 | Barton Physical Therapy, Inc. | Physical Therapist | 28720 Roadside Dr, #149, Agoura Hills, CA 91301-3316 | 2006-05-24 |
| 1073063624 | Amy Sever | Social Worker | 28720 Roadside Dr, Suite 196, Agoura Hills, CA 91301-3316 | 2016-10-06 |
| 1396181574 | Amanda Coddington | Chiropractor | 28720 Roadside Dr, Ste 335, Agoura Hills, CA 91301-3464 | 2013-05-15 |
| 1710224035 | California Interventional Pain Institute, LLC. | Clinic/Center | 28720 Roadside Dr, Suite 399, Agoura Hills, CA 91301-3316 | 2013-01-07 |
| 1841540721 | Jackson Fraser | Physician Assistant | 28720 Roadside Dr, Suite 399, Agoura Hills, CA 91301-3316 | 2012-09-18 |
| 1255681235 | Michael E Steuer, Md, PC | Specialist | 28720 Roadside Dr, Suite 399, Agoura Hills, CA 91301-3316 | 2012-09-17 |
| 1740235985 | Nicolas Barton | Physical Therapist | 28720 Roadside Dr, Agoura Hills, CA 91301-3317 | 2006-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770126823 | Krista Marie Windisch | Technician | 5836 Stonecrest Drive, Agoura, CA 91301 | 2019-10-22 |
| 1154872372 | Evolve Growth Initiatives LLC | Clinic/Center | 6425 Chesebro Road, Agoura, CA 91301 | 2016-10-24 |
| 1760851224 | Robert Kevin Ryan | Counselor | 28310 Roadside Drive Suite 235, Agoura Hills, CA 91301 | 2015-09-15 |
| 1922484054 | Mahyar Okhovat, M.d. Inc | Psychiatry & Neurology | 2925 Canwood St, 109, Agoural Hills, CA 91301 | 2015-07-30 |
| 1982083929 | Alfred Charles Deciutiis Jr. | Internal Medicine | 32062 1/2 Lobo Canyon, Agoura, CA 91301 | 2015-05-22 |
| 1821401787 | Brandie Boghosian | Psychologist | 30200 Agoura Rd Ste 190, Agoura, CA 91301 | 2014-06-09 |
| 1114339041 | Unique Care Los Angeles Hospice, Inc. | Hospice Care, Community Based | 27001 Agoura Rd #110, Calabasas, CA 91301 | 2014-05-27 |
| 1588905574 | Irit Almog | Marriage & Family Therapist | 5308 Derry Ave Ste L201, Agoura Hills, CA 91301 | 2013-03-15 |
| 1902152507 | Bethany Vaudrey | Psychologist | 28328 Agoura Rd Ste 102, Agoura Hills, CA 91301 | 2012-08-01 |
| 1508142472 | Jill Torres | Psychologist | 28729 Roadside Dr Ste 151, Agoura Hills, CA 91301 | 2011-10-24 |
| Find all providers in zip 91301 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| 1104435734 | New Life Health Authority / Dba New Life LLC | Clinic/Center | 280 E Standley St, Ukiah, CA 95482-4414 | 2020-07-29 |
| 1043829971 | House of Hope Foundation Inc | Clinic/Center | 227 W 9th St, San Pedro, CA 90731-3711 | 2020-07-27 |
| Find all providers with the same taxonomy | ||||
| City | AGOURA HILLS |
| Zip Code | 91301 |
Please comment or provide details below to improve the information on AGOURA NEUROFEEDBACK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.