| NPI | 1134986607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON CALLOWAY Owner/Authorized Official 310-651-4279 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2024-03-01 |
| Last Update Date | 2024-03-01 |