| NPI | 1003001009 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD A KOTKIN Clinical Professor 949-824-6292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA psy12351) |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2007-09-14 |