| NPI | 1144463563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN VENN President 619-692-3736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY 22538) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: CA PSY 22538) |
| 103TF0200X Psychologist, Forensic (Licence: CA PSY 22538) | |
| Enumeration Date | 2009-04-15 |
| Last Update Date | 2009-04-15 |