| NPI | 1346652187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNICA RACHEL JENKINS President Clinical Director 916-747-3799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: CA LPCC26) |
| Additional Taxonomies | 251S00000X (Licence: CO LPC6072) |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2014-05-28 |