Provider Demographics
NPI:1710236559
Name:PALAFOX PSYCHOLOGICAL CORPORATION
Entity Type:Organization
Organization Name:PALAFOX PSYCHOLOGICAL CORPORATION
Other - Org Name:MEANINGFUL GROWTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GWENNYTH
Authorized Official - Middle Name:
Authorized Official - Last Name:PALAFOX
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:626-795-4092
Mailing Address - Street 1:1001 S. MARENGO AVENUE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106
Mailing Address - Country:US
Mailing Address - Phone:626-795-4092
Mailing Address - Fax:626-795-9505
Practice Address - Street 1:1001 S. MARENGO AVENUE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106
Practice Address - Country:US
Practice Address - Phone:626-795-4092
Practice Address - Fax:626-795-9505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-07
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-12-11540103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty