| NPI | 1679941983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE WILKENS Clinical Psychologist 323-375-8175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA PSY25549) |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2015-09-03 |
| Last Update Date | 2023-07-18 |