| NPI | 1043981020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD P DIAZ Director 726-208-7900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2021-09-21 |
| Last Update Date | 2022-11-21 |