| NPI | 1457638124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY J BAKER-ERICZEN Director 858-205-9809 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA Psy17553) |
| Additional Taxonomies | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: CA Psy23448) |
| Enumeration Date | 2011-11-09 |
| Last Update Date | 2011-11-09 |