| NPI | 1164566881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY KELSO Psychologist 805-379-9600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY10466) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2007-09-28 |