| NPI | 1992240279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M CARRILLO Director 951-777-8176 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 77468) |
| Enumeration Date | 2016-12-22 |
| Last Update Date | 2016-12-22 |