| NPI | 1023899481 |
|---|---|
| Doing Business As | DEZAK MENTAL HEALTH PROVIDRS |
| Entity Type | Organization |
| Authorized Contact | KRISTINE MBAMALU Owner 310-531-6645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 163W00000X Registered Nurse |
| Enumeration Date | 2023-10-11 |
| Last Update Date | 2023-10-12 |