| NPI | 1043682586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM SHEA President 619-466-0370 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY11450) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY14791) |
| 103TC0700X Psychologist, Clinical (Licence: CA PSY4650) | |
| 103TC0700X Psychologist, Clinical (Licence: CA PSY12736) | |
| 103TC0700X Psychologist, Clinical (Licence: CA PSY4623) | |
| 103TC0700X Psychologist, Clinical (Licence: CA PSY13951) | |
| 1041C0700X Social Worker, Clinical (Licence: CA LCS16379) | |
| 1041C0700X Social Worker, Clinical (Licence: CA LCS23229) | |
| 1041C0700X Social Worker, Clinical (Licence: CA LCS21925) | |
| Enumeration Date | 2015-10-23 |
| Last Update Date | 2015-11-02 |