| NPI | 1265941165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL ERNESTO BRUZZONE President 310-855-3990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 26003) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA 26003) |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: CA 26003) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA 26003) | |
| 103TC1900X Psychologist, Counseling (Licence: CA 26003) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA 26003) | |
| 103TF0000X Psychologist, Family (Licence: CA 26003) | |
| 103TF0200X Psychologist, Forensic (Licence: CA 26003) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: CA 26003) | |
| Enumeration Date | 2017-09-22 |
| Last Update Date | 2018-03-17 |