| NPI | 1710910104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW G YELLEN President 818-360-3078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY10756) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: CA PSY10756) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA PSY10756) | |
| 103TC0700X Psychologist, Clinical (Licence: CA PSY10756) | |
| 103TE1100X Psychologist, Exercise & Sports (Licence: CA PSY10756) | |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2012-03-01 |