| NPI | 1114722964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAEA JAMINE UMALI UPPALA President 909-754-3633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-02-17 |
| Last Update Date | 2025-02-17 |