Healthcare Provider Details

I. General information

NPI: 1538992060
Provider Name (Legal Business Name): ALEJANDRO PALOMINO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2024
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5178 ATLANTIC AVE
LONG BEACH CA
90805-6510
US

IV. Provider business mailing address

26722 ISABELLA PKWY APT 205
SANTA CLARITA CA
91351-5235
US

V. Phone/Fax

Practice location:
  • Phone: 562-556-7213
  • Fax:
Mailing address:
  • Phone: 949-386-0484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number18277
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: