| NPI | 1568951663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL KELLY ABBOTT Psychologist 209-596-4162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 70497) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA 27701) |
| Enumeration Date | 2018-05-03 |
| Last Update Date | 2018-05-03 |