| NPI | 1174392054 |
|---|---|
| Doing Business As | BLACKHAWK FAMILY DEVELOPMENT CENTER |
| Doing Business As | NEWPORT BEACH FAMILY DEVELOPMENT CENTER |
| Former Legal Business Name | SURINA KAMDAR MAZZOLA PROFESSIONAL PSYCHOLOGY CORPORATION |
| Doing Business As | FAMILY DEVELOPMENT COLLECTIVE |
| Entity Type | Organization |
| Authorized Contact | SERENA MAZZOLA President 925-549-2610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2023-12-20 |
| Last Update Date | 2023-12-20 |