| NPI | 1275150955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY ANN TOBIE CFO 909-987-1997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TB0200X Psychologist Cognitive & Behavioral |
| Additional Taxonomies | 103TC0700X Psychologist Clinical |
| 103TF0200X Psychologist Forensic | |
| 103TP0814X Psychologist Psychoanalysis | |
| 103TP2701X Psychologist Group Psychotherapy | |
| 1041C0700X Social Worker Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2020-06-29 |
| Last Update Date | 2020-08-09 |