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General NPI Number Information
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NPI Number | 1710236559
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Entity Type | Organization
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Legal Business Name | PALAFOX PSYCHOLOGICAL CORPORATION
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Dates
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Enumeration Date | 09/07/2012
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Last Update Date | 09/07/2012
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Provider Practice Location Address
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Address Line | 1001 S. MARENGO AVENUE
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City | PASADENA
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State | CA
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Zip | 91106
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Country | US
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Telephone | 626-795-4092
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Fax | 626-795-9505
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Provider Business Mailing Address
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Address Line | 1001 S. MARENGO AVENUE
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City | PASADENA
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State | CA
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Zip | 91106
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Country | US
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Telephone | 626-795-4092
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Fax | 626-795-9505
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. GWENNYTH PALAFOX
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Credential | PH.D
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Telephone | 626-795-4092
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-12-11540
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License Number State |
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