NPI | 1346964806 |
---|---|
Entity Type | Organization |
Authorized Contact | JENNIFER KALISVAART Owner 562-277-0834 |
Organization Subpart ? | No |
Primary Taxonomy | 208000000X Pediatrics |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
363L00000X Nurse Practitioner | |
Enumeration Date | 2022-09-28 |
Last Update Date | 2023-07-21 |