| NPI | 1144188145 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMAL VANCE Owner 323-801-6331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| 103TE1100X Psychologist, Exercise & Sports | |
| 103TC1900X Psychologist, Counseling | |
| 101YM0800X Counselor, Mental Health | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TF0000X Psychologist, Family | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 103TA0700X Psychologist, Adult Development & Aging | |
| 103TH0100X Psychologist, Health Service | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| Enumeration Date | 2026-01-10 |
| Last Update Date | 2026-01-12 |