| NPI | 1083914253 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK DEAN CHRISMAN Secretary 510-652-7011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2010-10-22 |
| Last Update Date | 2010-10-22 |