| Brain Wellness Center Pc | |
|
5401 Norris Canyon Rd Ste 304 San Ramon CA 94583-5408 | |
| (925) 837-1100 | |
| (925) 837-1112 |
| Full Name | Brain Wellness Center Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5401 Norris Canyon Rd Ste 304, San Ramon, California |
| Authorized Official Name and Position | Ali Hashemian (CENTER DIRECTOR) |
| Authorized Official Contact | 9258371100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brain Wellness Center Pc 5401 Norris Canyon Rd Ste 304 San Ramon CA 94583-5408 Ph: (925) 837-1100 | Brain Wellness Center Pc 5401 Norris Canyon Rd Ste 304 San Ramon CA 94583-5408 Ph: (925) 837-1100 |
| NPI Number | 1902356082 |
|---|---|
| Provider Enumeration Date | 10/12/2016 |
| Last Update Date | 02/28/2023 |
| Certification Date | 02/28/2023 |
| Medicare PECOS PAC ID | 9133552789 |
|---|---|
| Medicare Enrollment ID | O20191212000797 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902356082 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | G31269 (California) | Primary |
| Provider Name | Kerry Bruce Evnin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356536973 PECOS PAC ID: 3072638964 Enrollment ID: I20100922000140 |
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