| NPI | 1790023240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT E RECORD Licensed Clinical Psychologist 714-904-0679 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: CA PSY6946) |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: CA PSY6946) |
| Enumeration Date | 2013-01-17 |
| Last Update Date | 2016-01-04 |