| NPI | 1225635501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IXCHEL TELLEZ FONSECA Licensed Marriage Family Therapist 714-422-5773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2020-10-08 |
| Last Update Date | 2025-10-02 |