| NPI | 1679225536 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN LEILANI CHONG Practice Manager 385-396-7235 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2022-01-21 |
| Last Update Date | 2024-11-14 |