| NPI | 1184264533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE HAYDEN Clinical Supervisor 858-848-1766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Enumeration Date | 2020-01-14 |
| Last Update Date | 2020-01-14 |