| NPI | 1134658065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AZADEH GOLSHANI Psychologist 310-927-9853 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CA PSY28464) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: PSY28464) |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: CA psy28464) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2017-06-05 |