| NPI | 1093415481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE ELERY WERNER Administrator 949-569-9226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 103T00000X Psychologist |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2023-03-06 |
| Last Update Date | 2023-05-03 |