| NPI | 1003150830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN TOLK Executive Director 510-847-8797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA PSY22017) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA PSY22017) |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2012-11-16 |
| Last Update Date | 2012-11-16 |