| NPI | 1295020402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW LYNCH Intern Supervisor 714-836-2736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA psy 20127) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2011-06-15 |