Basic Information
| Provider Information | |||||||||
| NPI: | 1083194864 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PALLONE | ||||||||
| FirstName: | EMMA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21000 PLUMMER ST | ||||||||
| Address2: | |||||||||
| City: | CHATSWORTH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913114903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8188826400 | ||||||||
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| Practice Location | |||||||||
| Address1: | 660 E LOS ANGELES AVE STE B2 | ||||||||
| Address2: | |||||||||
| City: | SIMI VALLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930651884 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8052170168 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/21/2018 | ||||||||
| LastUpdateDate: | 11/18/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 113650 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.