| Southern California Neuropsychology Group | |
|
5950 Canoga Ave Ste 100 Woodland Hills CA 91367-5052 | |
| (818) 340-7700 | |
| (818) 340-7701 |
| Full Name | Southern California Neuropsychology Group |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 5950 Canoga Ave Ste 100, Woodland Hills, California |
| Authorized Official Name and Position | Michelle Conover (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 8183407700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern California Neuropsychology Group 5950 Canoga Ave Ste 100 Woodland Hills CA 91367-5052 Ph: (818) 340-7700 | Southern California Neuropsychology Group 5950 Canoga Ave Ste 100 Woodland Hills CA 91367-5052 Ph: (818) 340-7700 |
| NPI Number | 1740558253 |
|---|---|
| Provider Enumeration Date | 12/12/2011 |
| Last Update Date | 05/09/2024 |
| Certification Date | 05/09/2024 |
| Medicare PECOS PAC ID | 7618343443 |
|---|---|
| Medicare Enrollment ID | O20231214002318 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740558253 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | PSY21871 (California) | Primary |
| Provider Name | Michelle K Conover |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619126125 PECOS PAC ID: 4385093475 Enrollment ID: I20231214002560 |
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