| NPI | 1336410141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWYN ORTIZ-NANCE Clinical Director 559-635-4252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY 20528) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: CA PSY 20528) |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: CA PSY 20528) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA PSY 20528) | |
| 103TF0000X Psychologist, Family (Licence: CA PSY 20528) | |
| 103TF0200X Psychologist, Forensic (Licence: CA PSY 20528) | |
| 103TH0100X Psychologist, Health Service (Licence: CA PSY 20528) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: CA PSY 20525) | |
| Enumeration Date | 2012-01-25 |
| Last Update Date | 2012-01-25 |