| NPI | 1295947240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP PANNELL CEO 626-568-2949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: CA PSY11827) |
| Additional Taxonomies | 103TA0700X Psychologist Adult Development & Aging (Licence: CA PSY11827) |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: CA PSY11827) | |
| 103TC0700X Psychologist Clinical (Licence: CA PSY11827) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: CA PSY11827) | |
| 103TF0000X Psychologist Family (Licence: CA PSY11827) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |