Healthcare Provider Details

I. General information

NPI: 1659994739
Provider Name (Legal Business Name): JEY NEURO CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2020
Last Update Date: 03/25/2021
Certification Date: 03/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 CALLOWAY DR STE 100
BAKERSFIELD CA
93312-2513
US

IV. Provider business mailing address

6077 COFFEE RD #4 UNIT 310
BAKERSFIELD CA
93308-9416
US

V. Phone/Fax

Practice location:
  • Phone: 661-776-3876
  • Fax: 661-766-3876
Mailing address:
  • Phone: 661-776-3876
  • Fax: 661-766-3876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. VENKATESH JANAKIRAMAN
Title or Position: CEO
Credential: MD
Phone: 661-497-7999