| NPI | 1962783951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISA MARES Clinical Director 310-547-0084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: CA PSY 19781) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC 42200) |
| Enumeration Date | 2011-09-02 |
| Last Update Date | 2017-01-26 |