| NPI | 1952672297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEESHA PERKINS Director Of Credentialing 657-439-6178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-08-4069) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA OT 7404) |
| 235Z00000X Speech-Language Pathologist, (Licence: CA SP 9175) | |
| Enumeration Date | 2012-01-18 |
| Last Update Date | 2025-10-28 |