Provider Demographics
NPI:1467586099
Name:PALLICCIA, TORI (MA, LMFT)
Entity Type:Individual
Prefix:MS
First Name:TORI
Middle Name:
Last Name:PALLICCIA
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23501 PARK SORRENTO STE 214
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-1380
Mailing Address - Country:US
Mailing Address - Phone:818-514-3283
Mailing Address - Fax:
Practice Address - Street 1:23501 PARK SORRENTO STE 214
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-1380
Practice Address - Country:US
Practice Address - Phone:818-514-3283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MFC47454106H00000X
CA47454106H00000X
MFC 47454106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist