| NPI | 1962029371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNA ROSE BENAVIDEZ Owner 760-694-0327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 103TC0700X Psychologist, Clinical | |
| Enumeration Date | 2020-07-01 |
| Last Update Date | 2023-09-16 |