| NPI | 1942875117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISSA BAZINET Director Of Clinical Services 619-203-8403 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2021-05-20 |