| NPI | 1932233178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROCK KENNETH KILBOURNE Director 760-722-4233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY10467) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2008-10-20 |