| NPI | 1366048043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KANA NOOTENBOOM Clinical Director 949-419-5491 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 101YP1600X Counselor, Pastoral | |
| 101YP2500X Counselor, Professional | |
| 101YS0200X Counselor, School | |
| 1041C0700X Social Worker, Clinical | |
| 106E00000X Assistant Behavior Analyst | |
| 106S00000X Behavior Technician | |
| 133N00000X Nutritionist | |
| 133V00000X Dietitian, Registered | |
| Enumeration Date | 2020-12-08 |
| Last Update Date | 2020-12-21 |