| NPI | 1225884190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAZEL JAY Practictioner 510-415-2089 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YP1600X Counselor Pastoral |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-04-30 |
| Last Update Date | 2024-04-30 |