| NPI | 1245892637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNY BRAGANZA Credentailing Manager 562-403-4422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2019-07-05 |
| Last Update Date | 2019-07-05 |