| NPI | 1841543964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIENNE ELIZABETH PASEK Secretary 949-201-5779 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA PSY23321) |
| Enumeration Date | 2012-10-26 |
| Last Update Date | 2014-06-13 |