| NPI | 1932566882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON MARIE FOSTER President 916-716-9105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: FL PY 9339) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: FL PY 9339) |
| 103TC0700X Psychologist, Clinical (Licence: FL PY 9339) | |
| Enumeration Date | 2016-01-23 |
| Last Update Date | 2016-01-23 |