| NPI | 1982782991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE ROTH Psychologist 11 714-480-6600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA PSY11263) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2008-06-06 |