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 |