| NPI | 1790156271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA KLEIN Secretary 844-422-6336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY25565) |
| 103TC1900X Psychologist, Counseling (Licence: CA PSY19135) | |
| 1041C0700X Social Worker, Clinical (Licence: CA LCS59977) | |
| 106H00000X Marriage & Family Therapist (Licence: CA MFC48114) | |
| 133N00000X Nutritionist (Licence: CA AC11797) | |
| 171100000X Acupuncturist (Licence: CA AC11797) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A112538) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: CA A100456) | |
| 291U00000X Clinical Medical Laboratory (Licence: CA 05D2068012) | |
| Enumeration Date | 2015-10-09 |
| Last Update Date | 2015-10-09 |