| NPI | 1821122318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES LARRY (L) SHENK President, Director 858-450-1101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TB0200X Psychologist Cognitive & Behavioral | |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| 103TP2701X Psychologist Group Psychotherapy | |
| 1041C0700X Social Worker Clinical | |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2025-05-28 |