| NPI | 1518790104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MASSOODA PABAND Pmhnp 619-839-9684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2024-08-21 |
| Last Update Date | 2024-10-14 |