| NPI | 1760239594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LELAH SHARRA VILLALPANDO Clinical Psychologist 909-746-6963 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2024-04-30 |
| Last Update Date | 2025-09-15 |