Healthcare Provider Details

I. General information

NPI: 1902743412
Provider Name (Legal Business Name): PIEDMONT NEUROSCIENCE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3645 GRAND AVE STE 304
OAKLAND CA
94610-2040
US

IV. Provider business mailing address

3645 GRAND AVE STE 304
OAKLAND CA
94610-2040
US

V. Phone/Fax

Practice location:
  • Phone: 510-630-1201
  • Fax: 833-941-2254
Mailing address:
  • Phone: 510-630-1201
  • Fax: 833-941-2254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0301X
TaxonomyBrain Injury Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSHUA ELAN KULUVA
Title or Position: PRESIDENT
Credential: KULUVA
Phone: 510-630-1201