| Brainstim Centers, Inc | |
|
28212 Kelly Johnson Pkwy Ste 215 Valencia CA 91355-5090 | |
| (310) 314-8250 | |
| Not Available |
| Full Name | Brainstim Centers, Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 28212 Kelly Johnson Pkwy Ste 215, Valencia, California |
| Authorized Official Name and Position | Mark Liker (CEO) |
| Authorized Official Contact | 3103148250 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brainstim Centers, Inc 28212 Kelly Johnson Pkwy Ste 215 Valencia CA 91355-5090 Ph: (310) 314-8250 | Brainstim Centers, Inc 28212 Kelly Johnson Pkwy Ste 215 Valencia CA 91355-5090 Ph: (310) 314-8250 |
| NPI Number | 1518506229 |
|---|---|
| Provider Enumeration Date | 12/27/2019 |
| Last Update Date | 03/17/2025 |
| Certification Date | 03/17/2025 |
| Medicare PECOS PAC ID | 2062834161 |
|---|---|
| Medicare Enrollment ID | O20200618001332 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518506229 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Mark A Liker |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1407806292 PECOS PAC ID: 8123051042 Enrollment ID: I20050912001287 |
| Provider Name | Arjun C Reyes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194834424 PECOS PAC ID: 4486724150 Enrollment ID: I20080606000423 |
| Provider Name | Jacquelyn Victoria Zommick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073282786 PECOS PAC ID: 4880060540 Enrollment ID: I20221020001627 |
| Provider Name | Robert Glenn |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902033210 PECOS PAC ID: 9335328467 Enrollment ID: I20230410002293 |
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