| NPI | 1053825505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW WONG Owner 415-806-0275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP2701X Psychologist, Group Psychotherapy |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 224Z00000X Occupational Therapy Assistant | |
| Enumeration Date | 2017-11-20 |
| Last Update Date | 2017-11-20 |