| NPI | 1518362680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY JO MONSON B Illing Administrator 530-245-5808 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2014-10-30 |
| Last Update Date | 2020-01-17 |