| NPI | 1790812147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARICHU CARRION WOLMERATH Owner 714-841-1330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY16356) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC20709) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2012-01-31 |