| NPI | 1598179814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL TUCKER Psychologist 858-775-8040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA PSY23827) |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2014-06-13 |