| NPI | 1063723948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA K DIETZ Psychologist 415-833-4092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY 23391) |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2010-06-25 |