| NPI | 1649622994 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD LLOYD IVERSON President 805-698-1653 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY25457) |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2016-07-11 |