| NPI | 1750510046 |
|---|---|
| Doing Business As | PENINSULA FAMILY WELLNESS CENTER |
| Entity Type | Organization |
| Authorized Contact | JOSETTE MARIE CIOLINO Clinical Director 310-373-3420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY18122) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA IMF54831) |
| 101YM0800X Counselor, Mental Health (Licence: CA IMF49959) | |
| 101YM0800X Counselor, Mental Health (Licence: CA IMF58442) | |
| 103TC0700X Psychologist, Clinical (Licence: CA PSY22390) | |
| 106H00000X Marriage & Family Therapist (Licence: CA MFC45294) | |
| 106H00000X Marriage & Family Therapist (Licence: CA MFC42698) | |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2009-07-07 |