| NPI | 1033664727 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER M PARK Psychologist 408-426-5725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY27972) |
| Enumeration Date | 2016-08-23 |
| Last Update Date | 2016-08-23 |