| NPI | 1962730614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISSETTE DE LEON Mhcii 661-940-4052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA MFT 44041) |
| Enumeration Date | 2009-11-18 |
| Last Update Date | 2009-11-18 |