| NPI | 1831991694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRSTEN MANALO Owner And Provider 909-645-2500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-03-25 |
| Last Update Date | 2025-03-25 |