| NPI | 1588614846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY13930) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA MFT12314) |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: CA PSY13930) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA PSY13930) | |
| 103TC1900X Psychologist, Counseling (Licence: CA PSY13930) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY13930) | |
| 103TF0000X Psychologist, Family (Licence: CA PSY13930) | |
| 103TH0004X Psychologist, Health (Licence: CA PSY13930) | |
| 106H00000X Marriage & Family Therapist (Licence: CA MFT12314) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2016-04-28 |