| NPI | 1245053933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON BRETT LARICK Nurse Practitioner 626-963-4467 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-11-01 |
| Last Update Date | 2024-11-01 |