| NPI | 1992986616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK STEPHEN LUM Licensed Psychologist 949-713-9846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY13344) |
| Enumeration Date | 2007-11-21 |
| Last Update Date | 2007-11-21 |