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NPI Profile for KEYSTONE PEDIATRIC BEHAVIORAL HEALTH in SEAL BEACH, CA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Intellectual & Developmental Disabilities |
103TM1800X | 62 | Psychologist, Clinical |
| NPI Number | 1992169940 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 04/06/2016 | |
| Last updated | 04/06/2016 - About 10 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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KEYSTONE PEDIATRIC BEHAVIORAL HEALTH