| NPI | 1356764880 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NINA PETIT DE MANGE President 760-276-4606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY26000) |
| Enumeration Date | 2014-02-04 |
| Last Update Date | 2014-02-04 |