NPI | 1609582006 |
---|---|
Entity Type | Organization |
Authorized Contact | THASANEE FONG Chief Executive Officer 909-718-2721 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Enumeration Date | 2023-01-30 |
Last Update Date | 2023-03-01 |