| NPI | 1740556489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA MEGHAN TIEDEMANN-FULLER Licensed Clinical Psychologist 707-556-2356 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA PSY23513) |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2012-03-27 |