| NPI | 1609118165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINIQUE BENAVIDEZ Owner 310-373-0800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA PSY22620) |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2013-03-22 |