| NPI | 1104491349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISSA D BAZINET Clinical Psychologist 619-203-8403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2021-05-20 |