NPI | 1417848219 |
---|---|
Doing Business As | NEURODIVERGENT PSYCHIATRIC SPECIALISTS |
Entity Type | Organization |
Authorized Contact | JESSE ANTHONY BONILLA Executive Director 714-420-9890 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 208D00000X General Practice |
2084P0800X Psychiatry & Neurology, Psychiatry | |
363LP0808X Nurse Practitioner, Psych/Mental Health | |
Enumeration Date | 2025-07-10 |
Last Update Date | 2025-10-09 |