NPI | 1073645586 |
---|---|
Doing Business As | CSOC FAST |
Entity Type | Organization |
Authorized Contact | AVAMASAG SEMO Medical Records 831-755-4545 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
Enumeration Date | 2007-03-10 |
Last Update Date | 2023-09-26 |