| NPI | 1912430240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANESHA MORRIS Program Manager 559-396-0560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA PSY21346) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 171W00000X Contractor | |
| 251X00000X Supports Brokerage | |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2022-09-08 |