MEDICARE: PALEI ALFARO LMFT

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	101YM0800X	Mental Health Counselor
2	106H00000X	Marriage & Family Therapist	120183	CA

General Provider Information

NPI Number	:	1871994285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PALEI ALFARO LMFT

Provider Business Mailing Address
First Line	:	PO BOX 1087
Second Line	:
City	:	WATERFORD
State	:	CA
Zip	:	95386-1087
Country	:	US
Telephone Number	:	209-324-7420
Fax Number	:

Provider Business Practice Location Address
First Line	:	1111 W ROBINHOOD DR STE L
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95207-5626
Country	:	US
Telephone Number	:	844-867-8444
Fax Number	:

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

Provider Enumeration Date	:	09/05/2014
Last Update Date	:	10/10/2024

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