| NPI | 1134888902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONIA C CLARK Credentialing Manager 415-964-5137 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2021-12-09 |
| Last Update Date | 2022-06-09 |