Provider Demographics
NPI:1083308142
Name:PALACIO, HOPE H (ASW, MSW, MA)
Entity Type:Individual
Prefix:
First Name:HOPE
Middle Name:H
Last Name:PALACIO
Suffix:
Gender:F
Credentials:ASW, MSW, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28981 ALESSANDRO BLVD # 6290
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92555-6907
Mailing Address - Country:US
Mailing Address - Phone:909-206-5284
Mailing Address - Fax:
Practice Address - Street 1:14597 EVEREST WAY
Practice Address - Street 2:
Practice Address - City:RANCHO BELAGO
Practice Address - State:CA
Practice Address - Zip Code:92555-7026
Practice Address - Country:US
Practice Address - Phone:909-206-5284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1022331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical