| NPI | 1891955936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIAN CORTEZ Lead Credentialing Specialist 619-781-2418 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: UT 89-115803-2501) |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2024-03-26 |