| NPI | 1528776945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER M. SANDOVAL Director 657-217-1141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| Enumeration Date | 2022-11-15 |
| Last Update Date | 2022-11-15 |