| NPI | 1073663605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA JENKINS Administrator 951-341-8935 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 1041C0700X Social Worker Clinical | |
| 2084P0805X Psychiatry & Neurology Geriatric Psychiatry | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2017-04-21 |