SLATEDM NEURO, PC (NPI# 1598379364) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598379364 |
| Entity Type | Organization |
| Organization Name | SLATEDM NEURO, PC |
| Practice Address |
23961 Calle De La Magdalena Ste 504 Laguna Hills CA 92653-3665 |
| Mailing Address |
5080 Spectrum Dr Ste 1100e Addison TX 75001-4688 |
| Practice Telephone | 9165881894 |
| Enumeration Date | 2020-08-31 |
| Last Update Date | 2020-08-31 |
| Authorized Official Name | FELICIA ALDERETE (LEGAL OPERATION MANAGER) |
| Authorized Official Telephone | 2105982800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 204R00000X | Electrodiagnostic Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians | ||
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| N | 246ZE0600X |
Specialist/Technologist, Other Specialization: Electroneurodiagnostic |
Technologists, Technicians & Other Technical Service Providers | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 2084N0600X |
Psychiatry & Neurology Specialization: Clinical Neurophysiology |
Allopathic & Osteopathic Physicians |
| Street Address |
23961 CALLE DE LA MAGDALENA STE 504 |
| City | LAGUNA HILLS |
| State | CA |
| Zip Code | 92653-3665 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780199349 | Lauren Christine Heinze | Physician Assistant | 23961 Calle De La Magdalena Ste 504, Laguna Hills, CA 92653-3665 | 2017-12-05 |
| 1790258788 | Kylie Peterman | Physician Assistant | 23961 Calle De La Magdalena Ste 504, Laguna Hills, CA 92653-3665 | 2019-01-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932708476 | Nikkie Veyseh | Behavior Technician | 26921 Falling Leaf Dr., Laguna Hills, CA 92653 | 2020-10-24 |
| 1609480425 | Steve Ceja | Behavior Technician | 25201 Paseo De Alicia Suite 110, Laguna Hills, CA 92653 | 2020-08-31 |
| 1467006882 | Kristina Alexa Puno Morales | Dietitian, Registered | 24552 Health Center Drive, Laguna Hills, CA 92653 | 2019-07-25 |
| 1164929626 | Shoreline Consulting Services, Inc. | Clinic/Center | 23010 Lake Forest Drive, Suite B, Laguna Hills, CA 92653 | 2018-04-11 |
| 1023511045 | Performance Health Medical Group | Non-Pharmacy Dispensing Site | 25431 Cabot Road Suite 118, Laguna Hills, CA 92653 | 2018-03-15 |
| 1831613850 | Stephani A Berg | Physical Medicine & Rehabilitation | 24422 Avenida De La Carlota Suite 190, Laguna Hills, CA 92653 | 2017-08-01 |
| 1497299945 | Stephanie Lyle | Nurse Practitioner | 24221 Calle De Louisa, Suite 400, Laguna Hills, CA 92653 | 2016-12-16 |
| 1053776278 | Meillanny Gladness | Counselor | 23151 Verdugo Dr Ste 203, Laguna Hills, CA 92653 | 2015-12-16 |
| 1912383183 | Pmdca, LLC | Clinical Medical Laboratory | 23297 S Pointe Dr Ste 100, Laguna Hills, CA 92653 | 2015-08-10 |
| 1821486630 | 4mpw, Inc. | Home Health | 23232 Peralta Drive 216, Laguan Hills, CA 92653 | 2014-12-31 |
| Find all providers in zip 92653 | ||||
| Taxonomy Code | 2084N0600X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Clinical Neurophysiology |
| Clinical Neurophysiology is a subspecialty with psychiatric or neurologic expertise in the diagnosis and management of central, peripheral, and autonomic nervous system disorders using combined clinical evaluation and electrophysiologic testing such as electroencephalography (EEG), electromyography (EMG), and nerve conduction studies (NCS). |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316560378 | Green Flash Physician Oversight PC | Psychiatry & Neurology | 2868 Bayside Walk Unit C, San Diego, CA 92109-8119 | 2020-05-26 |
| 1659994739 | Jey Neuro Center, Inc | Psychiatry & Neurology | 2005 Eye Street #8-501, Bakersfield, CA 93301-4451 | 2020-05-22 |
| 1578116877 | La Neuro Medical Group | Psychiatry & Neurology | 11843 Dorothy St Apt 2, Los Angeles, CA 90049-4456 | 2019-07-17 |
| 1518527613 | Neuroguard Pro | Psychiatry & Neurology | 2932 N Cottonwood St Unit 16, Orange, CA 92865-1235 | 2019-06-19 |
| 1750857801 | Tms Depression Center of San Diego | Psychiatry & Neurology | 613 W Valley Pkwy Ste 102, Escondido, CA 92025-2550 | 2018-10-16 |
| 1225530637 | Iom Neuro Pro Reader | Psychiatry & Neurology | 9300 Santa Anita Ave, Suite 101, Rancho Cucamonga, CA 91730 | 2018-03-01 |
| 1437579851 | Sami Bajwa | Psychiatry & Neurology | 7240 N Van Ness Blvd, Fresno, CA 93711-0470 | 2014-04-24 |
| 1780935130 | Dawn Eliashiv Md Inc. A Professional Medical Corporation | Psychiatry & Neurology | 8635 W 3rd St Ste 1080w, Los Angeles, CA 90048-6183 | 2012-09-25 |
| 1073821922 | Yuvraj Singh Grewal | Psychiatry & Neurology | 23861 Mcbean Pkwy Ste A4, Santa Clarita, CA 91355-2003 | 2010-09-14 |
| 1952629263 | Roger Bertoldi Md Professional Corporation | Psychiatry & Neurology | 8610 S. Sepulveda Blvd., Los Angeles, CA 90045 | 2010-05-11 |
| Find all providers with the same taxonomy | ||||
| City | LAGUNA HILLS |
| Zip Code | 92653 |
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| 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.