Provider Demographics
NPI:1174632996
Name:PALDA, ANA SYLVIA (MS, MA)
Entity Type:Individual
Prefix:MS
First Name:ANA
Middle Name:SYLVIA
Last Name:PALDA
Suffix:
Gender:F
Credentials:MS, MA
Other - Prefix:MS
Other - First Name:SYLVIA
Other - Middle Name:
Other - Last Name:PALDA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, MA
Mailing Address - Street 1:PO BOX 2462
Mailing Address - Street 2:
Mailing Address - City:CAPISTRANO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92624-0462
Mailing Address - Country:US
Mailing Address - Phone:949-244-5781
Mailing Address - Fax:
Practice Address - Street 1:34052 LA PLAZA STE 107
Practice Address - Street 2:
Practice Address - City:DANA POINT
Practice Address - State:CA
Practice Address - Zip Code:92629-2571
Practice Address - Country:US
Practice Address - Phone:949-244-5781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2020-03-25
Deactivation Date:2019-10-04
Deactivation Code:
Reactivation Date:2020-03-25
Provider Licenses
StateLicense IDTaxonomies
CA46663106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist