| NPI | 1255541074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID A GORDON Owner Vice President 916-984-9148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA Psy6640) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-08-22 |