| NPI | 1962869354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA C BLUM Licensed Clinical Psychologist 323-633-6138 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY 19790) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC86294) |
| Enumeration Date | 2016-01-15 |
| Last Update Date | 2016-01-15 |