| NPI | 1699158634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIKI MOORE Office Manager 707-445-4705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: CA G59380) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2024-10-16 |