| NPI | 1972780575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE E SHELL Billing Agent 760-539-7700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA C33286) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA LCS9115) |
| Enumeration Date | 2008-01-25 |
| Last Update Date | 2014-11-03 |