MEDICARE: MARIO FERNANDO PALACIOS MFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	IMF51174	CA
2	106H00000X	Marriage & Family Therapist	46078	CA

General Provider Information

NPI Number	:	1518090018
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIO FERNANDO PALACIOS MFT

Provider Business Mailing Address
First Line	:	5556 S CENTINELA AVE # 9
Second Line	:	#304
City	:	LOS ANGELES
State	:	CA
Zip	:	90066-6912
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5556 S CENTINELA AVE # 9
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90066-6912
Country	:	US
Telephone Number	:	310-384-3922
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	07/05/2023

Similar Medicare Providers

1770048951 — MARIO PALACIOS THERAPY
Practice Location Address:

5556 S CENTINELA AVE
LOS ANGELES, CA
90066-6912

Practice Phone: 310-384-3922
Practice Fax:

1972336659 — GAIK IMM YEO
Practice Location Address:

3764 TILDEN AVE
LOS ANGELES, CA
90034-6912

Practice Phone: 310-447-4545
Practice Fax:

1992642243 — MARKETON STUDIOS
Practice Location Address:

3450 SAWTELLE BLVD APT 261
LOS ANGELES, CA
90066-2167

Practice Phone: 213-245-1571
Practice Fax:

1467389346 — DR. AFSHAN WILAYAT MOHIUDDIN DDS
Practice Location Address:

3360 SAWTELLE BLVD APT 112
LOS ANGELES, CA
90066-1626

Practice Phone: 818-626-7188
Practice Fax:

1417885732 — DR. SAMANTHA SHELTON-CHARLES
Practice Location Address:

12405 VENICE BLVD # 230
LOS ANGELES, CA
90066-3803

Practice Phone: 702-239-9800
Practice Fax:

1689677122 — DR. SUSAN CANNING M.D.
Practice Location Address:

3966 MARCASEL AVE
LOS ANGELES, CA
90066-4616

Practice Phone: 949-482-1930
Practice Fax: 216-273-9998

Directions to “ MARIO FERNANDO PALACIOS MFT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.