| NPI | 1205433083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORA JASON Clinical Director 949-943-1877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2020-10-05 |
| Last Update Date | 2020-10-05 |