# WEST WAVE NEURODIAGNOSTICS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922698091
- **Authorized official:** JESSICA JEWEL MORROW R.EEGT (OWNER, REGISTERED EEG TECHNOLOGIST)
- **Authorized official phone:** (805) 540-1160

## Contact information

- **Practice address:** 937 E MAIN ST STE 107, SANTA MARIA, CA 93454-5309
- **Practice address phone:** (805) 357-5272
- **Practice address fax:** (805) 308-7107
- **Mailing address:** 937 E MAIN ST STE 107, SANTA MARIA, CA 93454-5309
- **Mailing address phone:** (805) 357-5272
- **Mailing address fax:** (805) 308-7107

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 156F00000X | Technician/Technologist | — | — | Yes |

## Other

- **Enumeration date:** 01/22/2021
- **Last updated:** 05/05/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | EIN | THE EIN FOR THIS COMPANY WAS NOT BY MEDICARE. | CA |