Provider Demographics
NPI:1245035039
Name:RALLAMA, GERARD
Entity type:Individual
Prefix:MR
First Name:GERARD
Middle Name:
Last Name:RALLAMA
Suffix:
Gender:
Credentials:
Other - Prefix:MR
Other - First Name:GERARDO
Other - Middle Name:DIZON
Other - Last Name:RALLAMA
Other - Suffix:III
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14155 ORO GRANDE ST # A
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-2991
Mailing Address - Country:US
Mailing Address - Phone:818-926-5768
Mailing Address - Fax:
Practice Address - Street 1:1000 S FREMONT AVE BLDG A10
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91803-8800
Practice Address - Country:US
Practice Address - Phone:626-349-3838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-15
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician