Healthcare Provider Details

I. General information

NPI: 1508733437
Provider Name (Legal Business Name): NEUROHEALTH NETWORK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2025
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 S MELROSE DR STE 207
VISTA CA
92081-6630
US

IV. Provider business mailing address

314 S MELROSE DR STE 207
VISTA CA
92081-6630
US

V. Phone/Fax

Practice location:
  • Phone: 619-535-9505
  • Fax: 760-538-3043
Mailing address:
  • Phone: 818-636-1580
  • Fax: 760-538-3043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: IDA BABAKHANYAN
Title or Position: CEO
Credential: PHD
Phone: 619-535-9505