| NPI | 1700692142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA CAPELLO CEO 949-922-0712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC0700X Psychologist Clinical | |
| 104100000X Social Worker | |
| 208200000X Plastic Surgery | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 251B00000X Case Management | |
| 261QH0100X Clinic/Center Health Service | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2024-12-10 |
| Last Update Date | 2024-12-10 |