| NPI | 1891014312 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE E SHELL Office Manager 760-295-2950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TA0700X Psychologist, Adult Development & Aging (Licence: CA PSY12078) |
| Enumeration Date | 2010-05-24 |
| Last Update Date | 2010-05-25 |