Glory Ann Palecek, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY7272 Issued in CA

Practice address

260 H Ave
Coronado, CA 92118-1222

Phone

(619) 519-2554

Fax

(619) 437-0225

NPI assigned

Nov 12, 2009

Last updated

Oct 29, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Palecek,Inc.

  • Clinical Psychologist
  • Coronado, CA
  • NPI 1679827778
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1257984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351468800000",
    "number": "1508193491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 H AVE",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921181222",
            "telephone_number": "619-519-2554",
            "fax_number": "619-435-7717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 H AVE",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921181222",
            "telephone_number": "619-519-2554",
            "fax_number": "619-437-0225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALECEK",
        "first_name": "GLORY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-12",
        "last_updated": "2012-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "PSY7272",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY7272",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY7272",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "1508193491",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lyssia O'Shaughnessy, MA
• Roger Oen, M.D.
• Lindsay Olson Mack, NP
• One Life Physical Therapy Inc
• P Paul Chillar MD PC
• Palecek,Inc.
• Pallia Orthopedics
• Chris S Pallia, MD
• Parmela Sawhney MD Inc
• Patrick R Yassini M D Inc

• Clinical Psychologist in Coronado, CA
• Providers in Coronado, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.