| NPI | 1003453804 |
|---|---|
| Former Legal Business Name | EMERALD SHORES PSYCHOLOGICAL CENTER |
| Entity Type | Organization |
| Authorized Contact | PAYAM JAFARI Psychologist 949-231-9968 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2019-11-30 |
| Last Update Date | 2024-08-17 |