| NPI | 1780791020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DON SUSSMAN Supervisor 650-688-3046 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA LCS11583) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2020-08-22 |