| NPI | 1538360722 |
|---|---|
| Other Name | FEE FOR SERVICE - PSYCHOLOGIST |
| Entity Type | Organization |
| Authorized Contact | RUBEN IMPERIAL Behavioral Health Interim Director 209-525-6225 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2019-10-11 |