| NPI | 1063473015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE Y FONG Practice Director/Psychologist 805-239-9595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY15121) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2009-05-14 |