Healthcare Provider Details

I. General information

NPI: 1316792799
Provider Name (Legal Business Name): BRAIN HEALTH USA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2024
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14541 DELANO ST
VAN NUYS CA
91411-2820
US

IV. Provider business mailing address

14541 DELANO ST
VAN NUYS CA
91411-2820
US

V. Phone/Fax

Practice location:
  • Phone: 877-515-8113
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: EHAB S YACOUB
Title or Position: CEO
Credential:
Phone: 877-515-8113