| NPI | 1912186628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIM L WIGAL Clinical Professor 949-824-1812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA psy14209) |
| Enumeration Date | 2007-10-30 |
| Last Update Date | 2007-11-07 |