Healthcare Provider Details

I. General information

NPI: 1003683970
Provider Name (Legal Business Name): NEUROVANA MEDICAL GROUP OF CALIFORNIA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2023
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2230 W CHAPMAN AVE STE 209
ORANGE CA
92868-2316
US

IV. Provider business mailing address

17706 HILLSIDE WAY
SANTA CLARITA CA
91350-5874
US

V. Phone/Fax

Practice location:
  • Phone: 626-556-7766
  • Fax:
Mailing address:
  • Phone: 626-556-7766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. EMERY CASON JAMERSON
Title or Position: OWNER
Credential: MD
Phone: 626-556-7766