| NPI | 1225787682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAYLENE BOOTH Billing 805-441-8398 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2022-03-22 |
| Last Update Date | 2022-03-22 |