| NPI | 1558955617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN GRANAS Administrator 408-836-0636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2021-03-01 |
| Last Update Date | 2021-03-01 |