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Organization
PALECEK,INC.
Active
Organization
PALECEK,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLORY ANN PALECEK PHD (PRESIDENT)
(619) 519-2554
Entity
Organization
Contact information
Practice address
260 H AVE, CORONADO, CA 92118-1222
(619) 519-2554
Mailing address
260 H AVE, CORONADO, CA 92118-1222
(619) 519-2554
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY7272
CA
103TC2200X
Clinical Child & Adolescent Psychologist
PSY7272
CA
103TF0000X
Family Psychologist
PST7272
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508193491
TRICARE
CA
Enumeration date
10/29/2012
Last updated
10/29/2012
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