| NPI | 1073828273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL JEFFERS CLARK Clinical Psychologist 916-739-1926 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY 20715) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY 20715) |
| 103TF0000X Psychologist, Family (Licence: CA PSY 20715) | |
| 1041C0700X Social Worker, Clinical (Licence: CA LCS 24412) | |
| 106H00000X Marriage & Family Therapist (Licence: CA MFC 36061) | |
| Enumeration Date | 2010-08-11 |
| Last Update Date | 2010-08-11 |