Healthcare Provider Details

I. General information

NPI: 1609756972
Provider Name (Legal Business Name): BRAIN CENTRIC NEUROPSYCHOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2025
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 TOWNSGATE RD STE 102
WESTLAKE VILLAGE CA
91361-3034
US

IV. Provider business mailing address

2801 TOWNSGATE RD STE 102
WESTLAKE VILLAGE CA
91361-3034
US

V. Phone/Fax

Practice location:
  • Phone: 805-956-6000
  • Fax: 805-855-6652
Mailing address:
  • Phone: 805-956-6000
  • Fax: 805-855-6652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. SHANNEL H.K. ELHELOU
Title or Position: NEUROPSYCHOLOGIST
Credential: PSY.D.
Phone: 805-956-6000