Healthcare Provider Details

I. General information

NPI: 1619514676
Provider Name (Legal Business Name): HEIDI PALAFOX AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2019
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 GEER RD
TURLOCK CA
95380-3311
US

IV. Provider business mailing address

8345 ACACIA ST
HILMAR CA
95324-9095
US

V. Phone/Fax

Practice location:
  • Phone: 209-648-0208
  • Fax:
Mailing address:
  • Phone: 209-648-0208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number148002
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: