Provider Demographics
NPI:1982573267
Name:BRAIN, SCIENCE AND TECHNOLOGY INTEGRATIVE CENTER LLC
Entity type:Organization
Organization Name:BRAIN, SCIENCE AND TECHNOLOGY INTEGRATIVE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:SEBASTIEN
Authorized Official - Middle Name:ROBERT EDOUARD
Authorized Official - Last Name:MONTEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:949-220-6642
Mailing Address - Street 1:74710 CA-111
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260
Mailing Address - Country:US
Mailing Address - Phone:949-220-6642
Mailing Address - Fax:855-916-1830
Practice Address - Street 1:74710 CA-111
Practice Address - Street 2:SUITE 102
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260
Practice Address - Country:US
Practice Address - Phone:949-220-6642
Practice Address - Fax:855-916-1830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-04
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealthGroup - Multi-Specialty