| NPI | 1710485842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT157136) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional (Licence: CA APCC20228) | |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2018-01-23 |
| Last Update Date | 2025-08-14 |