| NPI | 1548022023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGENE M PERRY Operating Manager 510-815-2512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 103TP0016X Psychologist, Prescribing (Medical) | |
| Enumeration Date | 2024-01-29 |
| Last Update Date | 2024-01-29 |