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, Psych/Mental Health | |
Enumeration Date | 2022-05-17 |
Last Update Date | 2022-05-17 |