NPI | 1821131673 |
---|---|
Entity Type | Organization |
Authorized Contact | JUSTINE ANNE PETRIE President 714-990-0700 |
Organization Subpart ? | No |
Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: CA C38832) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA PSY6172) |
101YM0800X Counselor, Mental Health (Licence: CA PSY15282) | |
106H00000X Marriage & Family Therapist (Licence: CA ML012201) | |
Enumeration Date | 2007-02-14 |
Last Update Date | 2015-03-26 |