| NPI | 1073047072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA MEDIA Behavioral Health Clinician Iii 916-450-2650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA 96293) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2017-04-17 |