MEDICARE: NERVANA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician

General Provider Information

NPI Number	:	1881431559
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NERVANA

Provider Business Mailing Address
First Line	:	1752 E LUGONIA AVE STE 227
Second Line	:
City	:	REDLANDS
State	:	CA
Zip	:	92374-2730
Country	:	US
Telephone Number	:	951-335-0193
Fax Number	:	951-335-0194

Provider Business Practice Location Address
First Line	:	1752 E LUGONIA AVE STE 227
Second Line	:
City	:	REDLANDS
State	:	CA
Zip	:	92374-2730
Country	:	US
Telephone Number	:	951-335-0193
Fax Number	:	951-335-0194

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	DR. LISA HERRING SOVORY
Credential	:	MD
Telephone Number	:	951-335-0193

Provider Enumeration Date	:	07/10/2024
Last Update Date	:	07/10/2024

Similar Medicare Providers

1730041468 — ZACHARY PATTERSON BSN, RN, PHN
Practice Location Address:

1752 E LUGONIA AVE # 117-17
REDLANDS, CA
92374-2730

Practice Phone: 909-213-9488
Practice Fax:

1306843677 — DR. LISA HERRING SOVORY M.D.
Practice Location Address:

1752 E LUGONIA AVE STE 227
REDLANDS, CA
92374-2730

Practice Phone: 951-335-0193
Practice Fax: 951-335-0194

1669494118 — DEEPTI SAXENA MD
Practice Location Address:

1752 E LUGONIA AVE STE 117-1130
REDLANDS, CA
92374-2730

Practice Phone: 510-790-2116
Practice Fax: 510-344-8972

1013326966 — DR. CHRISTINA GWAK L.AC., O.M.D., PH.D.
Practice Location Address:

1752 E LUGONIA AVE , STE #110
REDLANDS, CA
92374-2730

Practice Phone: 909-794-1112
Practice Fax: 909-794-1115

1023854148 — JAMES BLOW
Practice Location Address:

1752 E LUGONIA AVE STE 117-1094
REDLANDS, CA
92374-2730

Practice Phone: 909-654-6798
Practice Fax:

1194542910 — ALEXIA BREE FOGLE
Practice Location Address:

1752 E LUGONIA AVE STE 117-1094
REDLANDS, CA
92374-2730

Practice Phone: 909-654-6798
Practice Fax:

Directions to “NERVANA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.