| NPI | 1457992430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY PARK CEO 805-504-6814 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology Behavioral Neurology & Neuropsychiatry |
| Enumeration Date | 2019-10-01 |
| Last Update Date | 2021-06-02 |