| NPI | 1356195184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMIAH CHAD MARTINEZ Vice President 909-560-0974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2024-04-17 |
| Last Update Date | 2024-08-22 |