| NPI | 1073026118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN WOOLLEY Psychologist 858-766-1179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2017-11-12 |
| Last Update Date | 2021-06-18 |