Provider Demographics
NPI:1003610304
Name:PALEGA, AMBER-ROSE
Entity type:Individual
Prefix:
First Name:AMBER-ROSE
Middle Name:
Last Name:PALEGA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8400 GRAPE ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90001-4132
Mailing Address - Country:US
Mailing Address - Phone:714-683-4243
Mailing Address - Fax:
Practice Address - Street 1:8400 GRAPE ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90001-4132
Practice Address - Country:US
Practice Address - Phone:714-683-4243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care