| NPI | 1285239798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA FUNK Credentialing Specialist 949-422-3609 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 102L00000X Psychoanalyst |
| 103T00000X Psychologist | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 106E00000X Assistant Behavior Analyst | |
| 106S00000X Behavior Technician | |
| 225X00000X Occupational Therapist | |
| 2355S0801X Specialist/Technologist, Speech-Language Assistant | |
| 224Z00000X Occupational Therapy Assistant | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2020-12-02 |
| Last Update Date | 2023-01-30 |