| NPI | 1497860068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESE ANTONIA TEN TUSSCHER Vice President Clinical Programs 415-750-4180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: CA PSY15889) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY20118) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2020-08-22 |