| NPI | 1609396183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH LEROY LARSON President/CEO 916-717-9368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY16221) |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2022-07-21 |