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General NPI Number Information
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NPI Number | 1376306159
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Entity Type | Organization
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Legal Business Name | PALADIN PSYCHOTHERAPY & FAMILY COUNSELING, INC
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Dates
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Enumeration Date | 02/05/2024
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 20201 FAIRWEATHER ST
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City | CANYON COUNTRY
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State | CA
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Zip | 91351-1050
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Country | US
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Telephone | 661-655-2779
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Fax |
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Provider Business Mailing Address
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Address Line | 19197 GOLDEN VALLEY RD # 842
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City | CANYON COUNTRY
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State | CA
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Zip | 91387-1428
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Country | US
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Telephone | 661-655-2779
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Fax |
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Authorized Official
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Title or Position | OWNER, CEO, PSYCHOTHERAPIST
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Name | CARISSA ARIEL LATAILLADE
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Credential |
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Telephone | 661-655-2779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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