| NPI | 1881091452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNE GILLESPIE Clinical Supervisor 408-975-2730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA psy18253) |
| Enumeration Date | 2014-11-26 |
| Last Update Date | 2014-11-26 |