| NPI | 1871664698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK C HEFFERNAN Owner 760-328-2286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY14471) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2017-11-22 |