MEDICARE: SHANA PALLOTTA

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	101YM0800X	Mental Health Counselor		CA

General Provider Information

NPI Number	:	1659837789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANA PALLOTTA

Provider Business Mailing Address
First Line	:	402 S MARENGO AVE
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91101-3113
Country	:	US
Telephone Number	:	323-999-5660
Fax Number	:

Provider Business Practice Location Address
First Line	:	402 S MARENGO AVE
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91101-3113
Country	:	US
Telephone Number	:	323-999-5660
Fax Number	:

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

Provider Enumeration Date	:	02/13/2019
Last Update Date	:	03/02/2026

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Directions to “ SHANA PALLOTTA ” Practice Location

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