Individual
DR. GLORY ANN PALECEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
260 H AVE, CORONADO, CA 92118-1222
(619) 519-2554
(619) 437-0225
Mailing address
260 H AVE, CORONADO, CA 92118-1222
(619) 519-2554
(619) 435-7717
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
PSY7272
CA
103TC0700X
Clinical Psychologist
Primary
PSY7272
CA
103TC2200X
Clinical Child & Adolescent Psychologist
PSY7272
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508193491
TRICARE
CA
Enumeration date
11/12/2009
Last updated
10/29/2012
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