| NPI | 1952964744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEROMY CRUZ ASIDO Owner 714-260-1215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2025-03-26 |