| Cerebral Medical Group, A Professional Corporation | |
|
330 N Brand Blvd Glendale CA 91203-2308 | |
| (415) 830-5946 | |
| (415) 651-3458 |
| Full Name | Cerebral Medical Group, A Professional Corporation |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 330 N Brand Blvd, Glendale, California |
| Authorized Official Name and Position | Michael Boggs (PRESIDENT) |
| Authorized Official Contact | 4158305946 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cerebral Medical Group, A Professional Corporation 2093 Philadelphia Pike # 9898 Claymont DE 19703-2424 Ph: (415) 830-5946 | Cerebral Medical Group, A Professional Corporation 330 N Brand Blvd Glendale CA 91203-2308 Ph: (415) 830-5946 |
| NPI Number | 1992355879 |
|---|---|
| Provider Enumeration Date | 09/12/2019 |
| Last Update Date | 02/27/2024 |
| Certification Date | 02/27/2024 |
| Medicare PECOS PAC ID | 6709206238 |
|---|---|
| Medicare Enrollment ID | O20210303000840 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992355879 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Kymberli Tremayne Williams Zeno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417041229 PECOS PAC ID: 5597730622 Enrollment ID: I20040831001497 |
| Provider Name | Rade B Vukmir |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1730177387 PECOS PAC ID: 5395659098 Enrollment ID: I20061030000560 |
| Provider Name | Laurel Blackman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194752576 PECOS PAC ID: 5294816773 Enrollment ID: I20080123000152 |
| Provider Name | Elizabeth C. Copes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578749479 PECOS PAC ID: 8123102035 Enrollment ID: I20080229000423 |
| Provider Name | Erin Haytaian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801149968 PECOS PAC ID: 5395996854 Enrollment ID: I20121108000636 |
| Provider Name | Kendra S Burton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407256530 PECOS PAC ID: 8820310048 Enrollment ID: I20141125000910 |
| Provider Name | Adanna U Oladejo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720420227 PECOS PAC ID: 6901040567 Enrollment ID: I20161003001237 |
| Provider Name | Kristen Nicole Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063943421 PECOS PAC ID: 1153697982 Enrollment ID: I20171024000666 |
| Provider Name | Clara Osakwe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497204267 PECOS PAC ID: 1153682026 Enrollment ID: I20180312000570 |
| Provider Name | Dawn Biddulph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851878102 PECOS PAC ID: 6204185598 Enrollment ID: I20180820002641 |
| Provider Name | Danielle Elana Gipson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518447911 PECOS PAC ID: 8426395948 Enrollment ID: I20190122003088 |
| Provider Name | Michael Besong Akwo-adelowo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881235646 PECOS PAC ID: 4284066291 Enrollment ID: I20191113001248 |
| Provider Name | Katrina Coulter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184255325 PECOS PAC ID: 2668801481 Enrollment ID: I20200330003714 |
| Provider Name | Kelly Ann Waldvogel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023668803 PECOS PAC ID: 8820428592 Enrollment ID: I20200420002930 |
| Provider Name | Sheila Dyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619332756 PECOS PAC ID: 3476857855 Enrollment ID: I20201119002348 |
| Provider Name | Kabiite Mukisa Okello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144818139 PECOS PAC ID: 2567875321 Enrollment ID: I20210115001406 |
| Provider Name | Carey L Krause |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457764672 PECOS PAC ID: 1658591474 Enrollment ID: I20210126001057 |
| Provider Name | Elizabeth Nnenna Emeri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649897174 PECOS PAC ID: 1355757857 Enrollment ID: I20210308002802 |
| Provider Name | Olapeju Fakeye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124642327 PECOS PAC ID: 2163838251 Enrollment ID: I20210316001393 |
| Provider Name | Amber N Lockman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265023881 PECOS PAC ID: 9335548882 Enrollment ID: I20210603000722 |
| Provider Name | Joyce Aiyeojenku |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780295485 PECOS PAC ID: 6608038393 Enrollment ID: I20210809001476 |
| Provider Name | Sajad Zalzala |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639311509 PECOS PAC ID: 5092962209 Enrollment ID: I20211105002031 |
| Provider Name | Adriana Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033715107 PECOS PAC ID: 4284041591 Enrollment ID: I20211105002114 |
| Provider Name | Brandi Rhoads |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396320461 PECOS PAC ID: 1658760806 Enrollment ID: I20211110001086 |
| Provider Name | Daniel Alan Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144801747 PECOS PAC ID: 8426447384 Enrollment ID: I20211115001326 |
| Provider Name | Lyssa Brooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184243628 PECOS PAC ID: 5092130377 Enrollment ID: I20211116001172 |
| Provider Name | Samantha H Juniker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619540937 PECOS PAC ID: 9133519630 Enrollment ID: I20211123002469 |
| Provider Name | Jeffrey Vernon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376786004 PECOS PAC ID: 1052447109 Enrollment ID: I20211123003258 |
| Provider Name | Johnny E Liner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124685045 PECOS PAC ID: 3173857208 Enrollment ID: I20211216000960 |
| Provider Name | Abiodun Adebisi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245714963 PECOS PAC ID: 3678800307 Enrollment ID: I20211223001329 |
| Provider Name | Emmanuel K Nji |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831793710 PECOS PAC ID: 4587077599 Enrollment ID: I20220104000288 |
| Provider Name | Shelly Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396330478 PECOS PAC ID: 0042608556 Enrollment ID: I20220105002956 |
| Provider Name | Jeanette Marjorie Shanholtzer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598926230 PECOS PAC ID: 8921347568 Enrollment ID: I20220112002553 |
| Provider Name | Tyisha Fletcher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144687047 PECOS PAC ID: 4981909827 Enrollment ID: I20220113001461 |
| Provider Name | Shalita Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396214060 PECOS PAC ID: 1153662283 Enrollment ID: I20220118002746 |
| Provider Name | Christopher Betley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922695501 PECOS PAC ID: 9537569777 Enrollment ID: I20220121000487 |
| Provider Name | Gina Rigsbee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598387425 PECOS PAC ID: 5496167934 Enrollment ID: I20220125002780 |
| Provider Name | Ammara Chaudhry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407432719 PECOS PAC ID: 0648662569 Enrollment ID: I20220201000640 |
| Provider Name | Meagan Petrek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376925974 PECOS PAC ID: 8022323195 Enrollment ID: I20220222002545 |
Dynamic Family Care Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 121 W Lexington Dr Ste L400a, Glendale, CA 91203 Phone: 818-334-9260 | |
Glendale Psychology Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1222 S Glendale Ave, Suite 4, Glendale, CA 91205 Phone: 818-551-1800 Fax: 844-272-6210 | |
Mending Souls Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1010 N Central Ave # 310, Glendale, CA 91202 Phone: 818-724-9770 Fax: 818-484-2991 | |
Prime Behavioral Solutions Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 121 W Lexington Dr Ste L300b, Glendale, CA 91203 Phone: 818-913-5254 Fax: 818-484-3423 | |
Pyles & Associates Aba Psychology Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 741 Glenvia St Ste 200, Glendale, CA 91206 Phone: 833-968-7762 Fax: 213-402-8600 | |
Power Of Now Corporation Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1315 E Harvard St Apt C, Glendale, CA 91205 Phone: 818-395-9796 | |
Meta Wellness Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 500 N Central Ave Ste 200, Glendale, CA 91203 Phone: 818-205-7662 |