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General NPI Number Information
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NPI Number | 1194362749
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Entity Type | Individual
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Provider Name | DANIELA PALLAFACCHINA PSYD, MAMFT
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Gender | Female
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Dates
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Enumeration Date | 12/03/2019
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Last Update Date | 12/03/2019
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Provider Practice Location Address
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Address Line | 3625 E THOUSAND OAKS BLVD STE 209
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91362-3566
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Country | US
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Telephone | 310-801-1406
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Fax |
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Provider Business Mailing Address
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Address Line | 4571 VIA PLUMA
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City | NEWBURY PARK
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State | CA
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Zip | 91320-6960
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Country | US
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Telephone | 310-801-1406
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSB94025174
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License Number State | CA
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