Provider Demographics
NPI:1437841814
Name:HEIMBERG NEUROPSYCHOLOGY - PSYCHOLOGICAL TESTING INC
Entity type:Organization
Organization Name:HEIMBERG NEUROPSYCHOLOGY - PSYCHOLOGICAL TESTING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:FREIBERG
Authorized Official - Last Name:HEIMBERG
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:646-687-1004
Mailing Address - Street 1:21300 DUMETZ RD APT G
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-4409
Mailing Address - Country:US
Mailing Address - Phone:646-687-1004
Mailing Address - Fax:855-943-3312
Practice Address - Street 1:5000 PARKWAY CALABASAS STE 218
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-3909
Practice Address - Country:US
Practice Address - Phone:424-234-1155
Practice Address - Fax:855-943-3312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-23
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0262737OtherNEW YORK LICENSE
CAPSY33820OtherCA LICENSE