| NPI | 1194120287 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKI COFFMAN CEO/President 951-900-4414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP2701X Psychologist Group Psychotherapy |
| Additional Taxonomies | 103TM1800X Psychologist Mental Retardation & Developmental Disabilities |
| Enumeration Date | 2014-10-31 |
| Last Update Date | 2024-03-17 |