| NPI | 1881219848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD MASON Credentialing Manager 530-868-6944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2020-06-15 |
| Last Update Date | 2026-01-20 |