| NPI | 1013345651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE I. DERMAN Psychologist 818-348-5133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA psy-3246) |
| Enumeration Date | 2013-10-16 |
| Last Update Date | 2013-12-31 |