| NPI | 1407216906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE PRIESING Founder 949-300-1657 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 14445) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 300630AP) |
| 101YM0800X Counselor, Mental Health (Licence: CA 300630AP) | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: CA 300630AP) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: CA 300630AP) | |
| 1041C0700X Social Worker, Clinical (Licence: CA 300630AP) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 14445) | |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2016-02-26 |