| NPI | 1912285859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWYN W ORTIZ-NANCE Clincal Psychologist 559-824-8934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WA PY 60221926) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: WA PY 60221926) |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: WA PY 60221926) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: WA PY60221926) | |
| Enumeration Date | 2011-07-26 |
| Last Update Date | 2011-07-26 |