Neural Vita Therapeutics

Primary specialty

Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X

Legal business name

NEURAL VITA THERAPEUTICS

Practice address

1804 Bacon St
San Diego, CA 92107-3004

Phone

(516) 395-2167

NPI assigned

Apr 21, 2026

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Jesse James Fowler

Title

Coo

Phone

(516) 395-2167

Specialties & licenses 14

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

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    "created_epoch": "1776729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776729600000",
    "number": "1134064652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 BACON ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921073004",
            "telephone_number": "516-395-2167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 BACON ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921073004",
            "telephone_number": "516-395-2167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURAL VITA THERAPEUTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-21",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "JESSE",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "516-395-2167",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1102X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military Outpatient Operational (Transportable) Component",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Research",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
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            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tatiana Alexandrovna Neumann, D.O.
• Claire Vivian Neumayer
• Diana Neuner, LICENSED MARRIAGE &
• Neurabello LLC (Neurabello)
• Neural Science Institute Inc.
• Troy Neureuter, DDS
• Neuro Science Institute (Crosby Center)
• Neurodynamics Inc
• Neuroevolve Integrative Health, a Professional Psychology Corporation (NeuroEvolve Integrative Health)
• Neurological Healing, Inc. (New Century Spine Centers)

• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in San Diego, CA
• Providers in San Diego, CA by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.