| NPI | 1982945689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT NILS JOHANSEN Owner Officer 562-860-2210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY10129) |
| Enumeration Date | 2013-03-06 |
| Last Update Date | 2013-03-06 |