| NPI | 1366001034 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS VAKOCH Chief Executive Officer 510-612-0097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2020-01-12 |