Provider Demographics
NPI:1255821419
Name:PALMIERI, CHARLES FRANCIS
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:FRANCIS
Last Name:PALMIERI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 ORANGE TREE LANE #250
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-4564
Mailing Address - Country:US
Mailing Address - Phone:909-030-7120
Mailing Address - Fax:
Practice Address - Street 1:1901 ORANGE TREE LANE
Practice Address - Street 2:#250
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-4564
Practice Address - Country:US
Practice Address - Phone:909-307-1204
Practice Address - Fax:909-335-3598
Is Sole Proprietor?:No
Enumeration Date:2018-05-14
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT20961106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist