| NPI | 1841611712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER MARTENS Chief Executive Officer 760-470-5731 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY25605) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: CA PSY25605) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA PSY25605) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY25605) | |
| 103TF0200X Psychologist, Forensic (Licence: CA PSY25605) | |
| 103TH0004X Psychologist, Health (Licence: CA PSY25605) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: CA PSY25605) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: CA PSY25605) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: CA PSY25605) | |
| Enumeration Date | 2013-12-19 |
| Last Update Date | 2025-02-23 |