| NPI | 1548096977 |
|---|---|
| Doing Business As | DIVISADERO HEALTH SERVICES CALIFORNIA, P.C. |
| Entity Type | Organization |
| Authorized Contact | KIMBERLY NEWELL GREEN Owner 415-496-5578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-09-11 |
| Last Update Date | 2024-09-11 |