Active NPI
Anthony Palaca
- Clinical Social Worker
- Stockton, CA
National Provider Identifier
1144971060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 91385
- Practice address
- 4545 Georgetown PL Ste A3
Stockton, CA 95207-6228 - Phone
- (209) 955-1139
- NPI assigned
- Jan 12, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 91385 | CA | |
| Clinical Social Worker | 1041C0700X | 91385 | CA | Primary |
Addresses
Primary practice location
4545 Georgetown PL Ste A3
Stockton, CA 95207-6228
Mailing address
4545 Georgetown PL Ste A3
Stockton, CA 95207-6228
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 91385 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704240000000",
"number": "1144971060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4545 GEORGETOWN PL STE A3",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952076228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4545 GEORGETOWN PL STE A3",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952076228",
"telephone_number": "209-955-1139"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALACA",
"first_name": "ANTHONY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-01-12",
"last_updated": "2024-01-03",
"certification_date": "2024-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "91385",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "91385",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.