| NPI | 1679310759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE MANE BULAONG Owner 510-754-1485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-07-15 |
| Last Update Date | 2024-07-15 |