| NPI | 1356824155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LA RAE C NEAL Clinical Psychologist 661-418-2918 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 101YP1600X Counselor Pastoral |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) | |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| 103TF0000X Psychologist Family | |
| 103TP2701X Psychologist Group Psychotherapy | |
| Enumeration Date | 2018-09-08 |
| Last Update Date | 2018-09-08 |