| NPI | 1588964159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH LOUISE SHANNON Founder 951-852-8505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 18946) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 18946) |
| Enumeration Date | 2010-10-28 |
| Last Update Date | 2010-10-28 |