Healthcare Provider Details

I. General information

NPI: 1932672045
Provider Name (Legal Business Name): MS. ALEJANDRA PALMA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2019
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 E SAN JACINTO AVE
PERRIS CA
92571-2833
US

IV. Provider business mailing address

600 CENTRAL AVE STE E1
LAKE ELSINORE CA
92530-2740
US

V. Phone/Fax

Practice location:
  • Phone: 951-210-1660
  • Fax:
Mailing address:
  • Phone: 951-471-1426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberB3702757
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberB3702757
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: