| NPI | 1386453934 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNY WEBB Office Manager 818-400-4579 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| Enumeration Date | 2025-01-07 |
| Last Update Date | 2025-01-07 |