Individual
MISS GRIZELLI-SHANE PADAMADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC 9228
Contact information
Practice address
5706 BALTIMORE DR UNIT 375, LA MESA, CA 91942-1685
(619) 567-7399
Mailing address
5706 BALTIMORE DR UNIT 375, LA MESA, CA 91942-1685
(909) 831-5887
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
CA
101YP2500X
Professional Counselor
Primary
LPCC9228
CA
Other
Enumeration date
02/18/2015
Last updated
08/29/2024
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