Basic Information
Provider Information
NPI: 1407126139
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PALAFOX
FirstName: JOSE
MiddleName: D
NamePrefix:  
NameSuffix:  
Credential: LMFT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1830 S. CENTRAL ST.
Address2:  
City: VISALIA
State: CA
PostalCode: 93277
CountryCode: US
TelephoneNumber: 5597302969
FaxNumber: 5597302991
Practice Location
Address1: 1029 N DEMAREE ST
Address2:  
City: VISALIA
State: CA
PostalCode: 932914117
CountryCode: US
TelephoneNumber: 5596799928
FaxNumber: 5596367874
Other Information
ProviderEnumerationDate: 01/11/2012
LastUpdateDate: 10/24/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  N Behavioral Health & Social Service ProvidersCounselorMental Health
106H00000X  N Behavioral Health & Social Service ProvidersMarriage & Family Therapist 
106H00000X74215CAN Behavioral Health & Social Service ProvidersMarriage & Family Therapist 
106H00000X108727CAY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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