| NPI | 1265361042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELIKA PANOVA BOHANNAN Executive Director 714-887-3816 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2026-05-18 |
| Last Update Date | 2026-05-18 |