Brain Longevity Center

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

G47623 Issued in CA

Legal business name

BRAIN LONGEVITY CENTER

Practice address

2100 Lynn Rd Ste 230
Thousand Oaks, CA 91360-8035

Phone

(805) 497-4500

Fax

(805) 495-1717

NPI assigned

May 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Lorne Sheldon Label, M.D.

Title

Medical Director

Phone

(805) 497-4500

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185321600000",
    "number": "1750503603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 LYNN RD STE 230",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913608035",
            "telephone_number": "805-497-4500",
            "fax_number": "805-495-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 LYNN RD STE 230",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913608035",
            "telephone_number": "805-497-4500",
            "fax_number": "805-495-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAIN LONGEVITY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-25",
        "status": "A",
        "authorized_official_last_name": "LABEL",
        "authorized_official_first_name": "LORNE",
        "authorized_official_middle_name": "SHELDON",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "805-497-4500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "G47623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Lynn Bowers-Dutra, OTR/L, CHT
• Tayler Boyle
• Bradley I. Spiegel, M.D., Inc.
• Cristina Bradley, DC
• Kim Braget
• Carlos Brain
• Pauntea Davina Bral, PA-C
• Julia Osborne Brandt
• Sumair Brar
• Brave Counseling and Consulting, a Family Counseling Corporation

• Neurology Physician in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Neurology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2007; 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.