| NPI | 1902648496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VAUGHN DANAO Administrator 818-299-3110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| 363LP2300X Nurse Practitioner Primary Care | |
| Enumeration Date | 2024-06-07 |
| Last Update Date | 2024-06-11 |