| NPI | 1255460648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSAY S MALCOLM Executive Director 510-430-1115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY23069) |
| Enumeration Date | 2007-03-03 |
| Last Update Date | 2022-09-23 |