Provider Demographics
NPI:1740346774
Name:PALUN, NICHOLAS ALEXANDER (LCSW)
Entity type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:ALEXANDER
Last Name:PALUN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:NICK
Other - Middle Name:A
Other - Last Name:PALUN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:1305 TOMMYDON ST
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95210-3364
Mailing Address - Country:US
Mailing Address - Phone:209-476-3348
Mailing Address - Fax:
Practice Address - Street 1:1305 TOMMYDON ST
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95210-3364
Practice Address - Country:US
Practice Address - Phone:209-476-3348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 229371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical