| NPI | 1639395858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERA STAMENKOVIC Mfcc 951-683-6322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC25858) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: CA MFC25858) |
| 305R00000X Preferred Provider Organization (Licence: CA MFC25858) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2014-08-26 |