| NPI | 1346457157 |
|---|---|
| Doing Business As | LIC MARRIAGE & |
| Entity Type | Organization |
| Authorized Contact | MCCOY DEAN HADDOCK CEO 661-326-8167 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY 8536) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA PSY 8536) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY 8536) | |
| 103TF0200X Psychologist, Forensic (Licence: CA PSY 8536) | |
| 103TH0100X Psychologist, Health Service (Licence: CA PSY 8536) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: CA PSY 8536) | |
| 103TP0016X Psychologist, Prescribing (Medical) (Licence: CA PSY 8536) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: CA Psy 8536) | |
| 106H00000X Marriage & Family Therapist (Licence: CA MI 13954) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2014-04-03 |