NPI | 1487205506 |
---|---|
Entity Type | Organization |
Authorized Contact | AMBER GUTIERREZ Credentialing 909-289-4075 |
Organization Subpart ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
103TC0700X Psychologist, Clinical | |
1041C0700X Social Worker, Clinical | |
106H00000X Marriage & Family Therapist | |
Enumeration Date | 2019-09-20 |
Last Update Date | 2019-12-17 |