Healthcare Provider Details

I. General information

NPI: 1962548875
Provider Name (Legal Business Name): CENTRE FOR NEURO SKILLS - L.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5411 ETIWANDA AVENUE, STE 300
TARZANA CA
91356
US

IV. Provider business mailing address

5215 ASHE ROAD
BAKERSFIELD CA
93313
US

V. Phone/Fax

Practice location:
  • Phone: 818-783-3800
  • Fax: 818-873-8412
Mailing address:
  • Phone: 661-872-3408
  • Fax: 661-872-5150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number9601311
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number960001311
License Number StateCA

VIII. Authorized Official

Name: NICHOLAS ASHLEY
Title or Position: SECRETARY
Credential:
Phone: 661-872-3408