| NPI | 1033070669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EXECUTIVE DIRECTOR Director 415-000-0000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 103TC1900X Psychologist, Counseling | |
| 103TC0700X Psychologist, Clinical | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2025-11-21 |
| Last Update Date | 2025-12-12 |