| NPI | 1770175291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRISCILLA NAAMOMO OTUBUAH CEO 909-985-5544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-02-05 |
| Last Update Date | 2021-02-05 |