| NPI | 1710718069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHON WHEATON Administrative Officer 619-782-0011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 103T00000X Psychologist |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2024-08-09 |
| Last Update Date | 2024-08-09 |