| NPI | 1689031528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACHARY DANE GINDER Executive Director 909-799-3777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: CA PSY24993) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY15160) |
| 103T00000X Psychologist (Licence: CA PSY23181) | |
| 103T00000X Psychologist (Licence: CA PSY25134) | |
| 174400000X Specialist (Licence: CA G46919) | |
| 174400000X Specialist (Licence: CA A118211) | |
| 174400000X Specialist (Licence: CA A239458) | |
| 225X00000X Occupational Therapist (Licence: CA 2683) | |
| Enumeration Date | 2016-01-22 |
| Last Update Date | 2023-08-01 |