| NPI | 1386327310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE KIRSCH CEO/Owner 510-385-1646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TM1800X Psychologist Mental Retardation & Developmental Disabilities |
| Additional Taxonomies | 103TC0700X Psychologist Clinical |
| 261QD1600X Clinic/Center Developmental Disabilities | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2023-08-08 |
| Last Update Date | 2023-08-08 |