| NPI | 1922990621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEIDRA RILEY Partner/Therapist 949-282-9667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 101YP1600X Counselor, Pastoral | |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2025-07-17 |
| Last Update Date | 2025-10-04 |