| NPI | 1144009721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACLYN NOBAKHT Provider, Owner 949-374-1696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-09-25 |
| Last Update Date | 2023-09-25 |