| NPI | 1205092053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY L LEWIS Office Manager 619-574-8181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CA SP1579) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| 305R00000X Preferred Provider Organization (Licence: CA SP1579) | |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2019-01-25 |