| NPI | 1730837535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE BASHEM Owner 949-889-2301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2022-03-11 |
| Last Update Date | 2022-04-07 |