Provider Demographics
NPI:1912061995
Name:PALAFOX, DIVINA (LPT)
Entity Type:Individual
Prefix:
First Name:DIVINA
Middle Name:
Last Name:PALAFOX
Suffix:
Gender:F
Credentials:LPT
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Mailing Address - Street 1:6221 VILLAGE GREEN DR
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95210-4607
Mailing Address - Country:US
Mailing Address - Phone:209-401-1134
Mailing Address - Fax:
Practice Address - Street 1:1839 S EL DORADO ST
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95206-2025
Practice Address - Country:US
Practice Address - Phone:209-463-0872
Practice Address - Fax:209-466-4446
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2023-06-22
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician