| NPI | 1316962269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL PENNY SMITH Sole Proprietor 310-370-9715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA A41530A) |
| Additional Taxonomies | 305S00000X Point of Service (Licence: CA A41530A) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2020-08-22 |