Healthcare Provider Details

I. General information

NPI: 1255277927
Provider Name (Legal Business Name): PALOMARES MARRIAGE AND FAMILY THERAPY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 S ORANGE GROVE BLVD
PASADENA CA
91105-1705
US

IV. Provider business mailing address

210 S ORANGE GROVE BLVD
PASADENA CA
91105-1705
US

V. Phone/Fax

Practice location:
  • Phone: 626-209-9055
  • Fax:
Mailing address:
  • Phone: 626-209-9055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. DANIELLE PALOMARES
Title or Position: OWNER
Credential: LMFT
Phone: 626-209-9055