Provider Demographics
NPI:1629786694
Name:FORONDA, PAMELA KATRINA L
Entity Type:Individual
Prefix:
First Name:PAMELA KATRINA
Middle Name:L
Last Name:FORONDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 E KATELLA AVENUE APT 1127 ANAHEIM CA, 92805
Mailing Address - Street 2:1048 IRVINE AVENUE #863
Mailing Address - City:NEWPORTBEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660
Mailing Address - Country:US
Mailing Address - Phone:714-675-0452
Mailing Address - Fax:
Practice Address - Street 1:1801 E KATELLA AVE APT 1127
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-6639
Practice Address - Country:US
Practice Address - Phone:714-675-0452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst