NPI | 1164169587 |
---|---|
Entity Type | Organization |
Authorized Contact | AMBER GUTIERREZ Provider Relations 909-289-4075 |
Organization Subpart ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
Additional Taxonomies | 103TC0700X Psychologist Clinical |
1041C0700X Social Worker Clinical | |
106H00000X Marriage & Family Therapist | |
363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
Enumeration Date | 2022-05-17 |
Last Update Date | 2022-05-17 |