| NPI | 1518000355 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL WATERMAN Clinic Coordinator 310-825-2305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY 6144) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2020-08-22 |