Healthcare Provider Details

I. General information

NPI: 1558284471
Provider Name (Legal Business Name): MICHAEL JAMES NEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18860 NORDHOFF ST STE 100
NORTHRIDGE CA
91324-3879
US

IV. Provider business mailing address

200 E ANGELENO AVE APT 214
BURBANK CA
91502-1375
US

V. Phone/Fax

Practice location:
  • Phone: 818-855-1788
  • Fax:
Mailing address:
  • Phone: 314-805-8345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: