| NPI | 1497156715 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRYN BRIDGET HERNANDEZ Mft Student 661-965-4152 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA 101y00000x) |
| Enumeration Date | 2014-09-05 |
| Last Update Date | 2014-09-05 |