MEDICARE: MS. TRENNELL ODESIA PALACIO MA, LPCC, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	90651	TX
2	101YP2500X	Professional Counselor	CP5491-R	NV
3	101YP2500X	Professional Counselor	12467	CA
4	101YS0200X	School Counselor	101YS0200X	CA

General Provider Information

NPI Number	:	1518202522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TRENNELL ODESIA PALACIO MA, LPCC, LPC

Provider Business Mailing Address
First Line	:	8939 S SEPULVEDA BLVD # 110-243
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-3631
Country	:	US
Telephone Number	:	877-643-6410
Fax Number	:

Provider Business Practice Location Address
First Line	:	8939 S SEPULVEDA BLVD # 110-243
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-3631
Country	:	US
Telephone Number	:	877-643-6410
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2012
Last Update Date	:	03/13/2026

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