| Valley Neurology Group | |
|
3400 Calloway Dr Ste 100 Bakersfield CA 93312-2513 | |
| (661) 776-3876 | |
| (661) 766-3876 |
| Full Name | Valley Neurology Group |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3400 Calloway Dr Ste 100, Bakersfield, California |
| Authorized Official Name and Position | Venkatesh Janakiraman (CEO) |
| Authorized Official Contact | 6614977999 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Valley Neurology Group 6077 Coffee Rd #4 Unit 310 Bakersfield CA 93308-9416 Ph: (661) 776-3876 | Valley Neurology Group 3400 Calloway Dr Ste 100 Bakersfield CA 93312-2513 Ph: (661) 776-3876 |
| NPI Number | 1659994739 |
|---|---|
| Provider Enumeration Date | 05/22/2020 |
| Last Update Date | 03/25/2021 |
| Certification Date | 03/25/2021 |
| Medicare PECOS PAC ID | 8820401649 |
|---|---|
| Medicare Enrollment ID | O20210114002989 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659994739 | NPI | - | NPPES |
| 1659994739 | Other | NPI | |
| CA446107 | Other | PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| 2084N0600X | Psychiatry & Neurology - Clinical Neurophysiology | (* (Not Available)) | Secondary |
| Provider Name | Vinutha N Ravi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1518946045 PECOS PAC ID: 1557512001 Enrollment ID: I20121112000040 |
| Provider Name | Venkatesh Janakiraman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1629331988 PECOS PAC ID: 5698907673 Enrollment ID: I20170818001195 |
| Provider Name | Lorelei D Punsalan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679990618 PECOS PAC ID: 4880827542 Enrollment ID: I20200204000524 |
| Provider Name | Megan Taylor Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215604392 PECOS PAC ID: 4880041292 Enrollment ID: I20231107001550 |
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