| NPI | 1215289608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VLADIMIR BOKARIUS Medical Director 510-323-2524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A84559) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA PSY22492) |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: CA PSB37064) | |
| Enumeration Date | 2012-10-09 |
| Last Update Date | 2012-10-09 |