| NPI | 1437325040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL F FULLER President, Clinical Psychologist 858-558-7707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA PSY16530) |
| Enumeration Date | 2008-05-03 |
| Last Update Date | 2008-05-03 |