Healthcare Provider Details

I. General information

NPI: 1245358928
Provider Name (Legal Business Name): MS. JILLIANNE PALADINO-BOYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3325 PALO VERDE AVE STE 202
LONG BEACH CA
90808-4132
US

IV. Provider business mailing address

3325 PALO VERDE AVE STE 202
LONG BEACH CA
90808-4132
US

V. Phone/Fax

Practice location:
  • Phone: 562-533-8616
  • Fax: 562-586-7116
Mailing address:
  • Phone: 562-533-8616
  • Fax: 156-253-3861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberP0404200946
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number125126
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: