| NPI | 1083942700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON BATHORI Director 650-323-1225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY22938) |
| Additional Taxonomies | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: CA PSY22938) |
| 103TP0814X Psychologist, Psychoanalysis (Licence: CA PSY22938) | |
| Enumeration Date | 2009-11-19 |
| Last Update Date | 2009-11-19 |