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General NPI Number Information
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NPI Number | 1366268096
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Entity Type | Individual
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Provider Name | ANNGELA PALACIO
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Gender | Female
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Dates
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Enumeration Date | 11/26/2024
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 5360 JACKSON DR STE 110
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City | LA MESA
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State | CA
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Zip | 91942-3012
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Country | US
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Telephone | 858-755-5200
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Fax |
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Provider Business Mailing Address
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Address Line | 5907 BATAAN CIR
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City | SAN DIEGO
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State | CA
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Zip | 92139-1523
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Country | US
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Telephone | 949-874-5596
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 27047
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License Number State | CA
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