| NPI | 1164575940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON ERIC STENSON Progarm Supervisor 510-374-7159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 16497) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2008-08-08 |