| NPI | 1720566128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH PORTER Director Of Operations 831-600-7103 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY24204) |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2021-02-01 |