NPIMap

Organization Active NPI

Palecek,Inc.

  • Clinical Psychologist
  • Coronado, CA
National Provider Identifier
1679827778
Registry record updated Oct 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY7272 Issued in CA
Legal business name
PALECEK,INC.
Practice address
260 H Ave
Coronado, CA 92118-1222
Phone
(619) 519-2554
NPI assigned
Oct 29, 2012
Last updated
Oct 29, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2012

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

Authorized official

Name
Dr. Glory Ann Palecek, PHDNPI 1508193491
Title
President
Phone
(619) 519-2554

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY7272 CA Primary
Clinical Child & Adolescent Psychologist 103TC2200X PSY7272 CA
Family Psychologist 103TF0000X PST7272 CA

Addresses

Primary practice location

260 H Ave
Coronado, CA 92118-1222

Mailing address

260 H Ave
Coronado, CA 92118-1222
Phone (619) 519-2554

Other identifiers 1

IdentifierTypeStateIssuer
1508193491OtherCATRICARE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1351468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351468800000",
    "number": "1679827778",
    "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"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALECEK,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-29",
        "last_updated": "2012-10-29",
        "status": "A",
        "authorized_official_last_name": "PALECEK",
        "authorized_official_first_name": "GLORY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-519-2554",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "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
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "CA",
            "license": "PST7272",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "1508193491",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coronado, CA

Sources for this page

  • 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.