Basic Information
| Provider Information | |||||||||
| NPI: | 1144363102 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PALICA | ||||||||
| FirstName: | JOANNA | ||||||||
| MiddleName: | JADWIGA | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8606 MACAWA AVE | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921232804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8586279964 | ||||||||
| FaxNumber: | 8586302246 | ||||||||
| Practice Location | |||||||||
| Address1: | 1630 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | EL CAJON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920215204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6195635300 | ||||||||
| FaxNumber: | 6195905155 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/15/2007 | ||||||||
| LastUpdateDate: | 11/01/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | A92228 | CA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.