| NPI | 1285189340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISHANA RIVAS Clinical Psychologist 818-800-5064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral |
| 103TC1900X Psychologist Counseling | |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| 103TF0000X Psychologist Family | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities | |
| 103TP2701X Psychologist Group Psychotherapy | |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2016-08-18 |