| NPI | 1629219845 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE FOREST Contract Specialist 858-966-7716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY22035) |
| Enumeration Date | 2009-03-18 |
| Last Update Date | 2009-03-18 |