| NPI | 1487703385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER GUDE Credentialing Manager 619-528-4600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 106H00000X Marriage & Family Therapist | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2015-11-12 |