| NPI | 1689473878 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAQUEL LACUESTA Managing Member 949-324-8363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry |
| Additional Taxonomies | 208D00000X General Practice |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2025-03-10 |
| Last Update Date | 2025-03-10 |