| NPI | 1851167506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA GOMEZ CEO 619-361-1207 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103TF0200X Psychologist, Forensic |
| 103TH0004X Psychologist, Health | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 103TA0700X Psychologist, Adult Development & Aging | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| Enumeration Date | 2023-12-04 |
| Last Update Date | 2023-12-04 |