| NPI | 1477316057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE IVIE Secretary 707-628-4140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2024-02-05 |
| Last Update Date | 2025-03-24 |