| NPI | 1750900478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICE ANN KUCHINSKAS Payer Relations 562-544-7823 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2020-04-13 |
| Last Update Date | 2020-04-13 |