| NPI | 1063278943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLETTE BAUTISTA CEO 916-234-6585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2024-02-27 |
| Last Update Date | 2024-02-27 |