NPI | 1457470825 |
---|---|
Entity Type | Organization |
Authorized Contact | EDWYN W ORTIZ-NANCE Clinical Director 559-635-4252 |
Organization Subpart ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY13698) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA MFC24170) |
103G00000X Clinical Neuropsychologist (Licence: CA PSY18170) | |
Enumeration Date | 2007-03-28 |
Last Update Date | 2012-01-11 |