| NPI | 1164150686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINE ANN RECENDEZ Therapist/Supervisor 916-295-2969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 103TC0700X Psychologist, Clinical | |
| Enumeration Date | 2022-08-11 |
| Last Update Date | 2023-07-27 |