Provider Demographics
NPI:1902392327
Name:PALOMINO, RAND (PHD)
Entity Type:Individual
Prefix:DR
First Name:RAND
Middle Name:
Last Name:PALOMINO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9311 MESA VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-4248
Mailing Address - Country:US
Mailing Address - Phone:619-337-3718
Mailing Address - Fax:
Practice Address - Street 1:3734 6TH AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-4317
Practice Address - Country:US
Practice Address - Phone:619-354-7400
Practice Address - Fax:619-574-6964
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-09
Last Update Date:2022-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY23458103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical