| NPI | 1417313586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ESTHER PARK President 949-258-3741 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 103TC0700X Psychologist Clinical |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry | |
| Enumeration Date | 2016-01-05 |
| Last Update Date | 2016-01-05 |