| NPI | 1720229578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHIE FAYE GUM Director 310-922-1698 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY 22467) |
| Enumeration Date | 2009-03-07 |
| Last Update Date | 2011-02-26 |