| Neuroedge Psychological Services, Inc. | |
|
964 El Segundo Dr Thousand Oaks CA 91362-2201 | |
| (310) 995-7427 | |
| Not Available |
| Full Name | Neuroedge Psychological Services, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 964 El Segundo Dr, Thousand Oaks, California |
| Authorized Official Name and Position | Beatrix Sibylle Wagner (CLINICAL PSYCHOLOGIST/CEO) |
| Authorized Official Contact | 3109957427 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Neuroedge Psychological Services, Inc. 964 El Segundo Dr Thousand Oaks CA 91362-2201 Ph: (310) 995-7427 | Neuroedge Psychological Services, Inc. 964 El Segundo Dr Thousand Oaks CA 91362-2201 Ph: (310) 995-7427 |
| NPI Number | 1275343857 |
|---|---|
| Provider Enumeration Date | 01/07/2025 |
| Last Update Date | 01/07/2025 |
| Certification Date | 01/07/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275343857 | NPI | - | NPPES |
| 1639358385 | Other | CA | ANTHEM BLUE CROSS |
| 1639358385 | Medicaid | CA | |
| 12409169 | Other | CA | ANTHEM BLUE CROSS |
| PG0112723001 | Other | CA | BLUE SHIELD OF CALIFORNIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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