| NPI | 1962755470 |
|---|---|
| Former Name | ALYSSA CRUZ JOHNSTON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 109429) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-10-22 |
| Last Update Date | 2019-08-26 |