| NPI | 1619435864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH MAUCH Clinical Psychologist 916-715-4741 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 251S00000X |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2019-03-06 |
| Last Update Date | 2019-03-06 |