| NPI | 1093425878 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY MWAURA Nurse Practitioner 909-714-7917 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-12-01 |
| Last Update Date | 2025-04-07 |