NPI | 1467051391 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL THEY Pmhnp 209-718-6240 |
Organization Subpart ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner |
Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2020-10-21 |
Last Update Date | 2023-07-18 |