Provider Demographics
NPI:1346372992
Name:PALOMAR FAMILY COUNSELING SERVICE, INC.
Entity Type:Organization
Organization Name:PALOMAR FAMILY COUNSELING SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WROLSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:760-731-3235
Mailing Address - Street 1:120 W HAWTHORNE ST
Mailing Address - Street 2:
Mailing Address - City:FALLBROOK
Mailing Address - State:CA
Mailing Address - Zip Code:92028-2053
Mailing Address - Country:US
Mailing Address - Phone:760-731-3235
Mailing Address - Fax:760-731-4950
Practice Address - Street 1:120 W HAWTHORNE ST
Practice Address - Street 2:
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-2053
Practice Address - Country:US
Practice Address - Phone:760-731-3235
Practice Address - Fax:760-731-4950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0000537EB251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health