| NPI | 1407492713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HELENEMICKEY WILSON President 714-743-5612 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 103TA0400X Psychologist Addiction (Substance Use Disorder) |
| 103TB0200X Psychologist Cognitive & Behavioral | |
| 103TC1900X Psychologist Counseling | |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| 103TF0000X Psychologist Family | |
| 103TP2701X Psychologist Group Psychotherapy | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2019-11-21 |
| Last Update Date | 2021-08-31 |