| NPI | 1124430038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES FORTMAN President 805-451-1463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: CA PSY26321) |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2018-09-08 |