| NPI | 1366829632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PONEVA HAMLIN Marriage Family Therapist Intern 415-710-2126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CA A6412408) |
| Enumeration Date | 2015-05-06 |
| Last Update Date | 2015-05-06 |