Healthcare Provider Details

I. General information

NPI: 1568858884
Provider Name (Legal Business Name): BARBARA PEDALINO PSY.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2015
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

76094 IMPATIENS CIR
PALM DESERT CA
92211-5079
US

IV. Provider business mailing address

PO BOX 10024
PALM DESERT CA
92255-0024
US

V. Phone/Fax

Practice location:
  • Phone: 760-702-0878
  • Fax: 760-702-4445
Mailing address:
  • Phone: 760-702-0878
  • Fax: 760-770-4445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number27163
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number27163
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number27163
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number27163
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: