Provider Demographics
NPI:1831654953
Name:PAPPALARDO, MICHAELA ELIZABETH
Entity Type:Individual
Prefix:MRS
First Name:MICHAELA
Middle Name:ELIZABETH
Last Name:PAPPALARDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MICHAELA
Other - Middle Name:ELIZABETH
Other - Last Name:ROBICHAUD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1650 SPRUCE ST STE 102
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-7403
Mailing Address - Country:US
Mailing Address - Phone:951-357-6926
Mailing Address - Fax:855-568-2494
Practice Address - Street 1:1650 SPRUCE ST STE 102
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-7403
Practice Address - Country:US
Practice Address - Phone:951-357-6926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-02
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician