Elizabeth Francisca Palko, PH.D.
Individual provider Active NPI Psychologist · Represa, CA
NPI 1821379306 · NPPES record last updated Apr 25, 2022
Key facts
- NPI
- 1821379306
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- PSY25803 (CA)
- Practice address
- 300 Prison Rd
Represa, CA 95671-9529 - Phone
- (916) 985-2561
- NPI assigned
- Aug 29, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY25803 | CA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Corrections and Rehabilitation-Headquarters | Current |
Accepting new patients |
Locations
300 Prison Rd
Represa, CA 95671
Phone (916) 985-2561
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY25803 | CA | Yes |
| Psychologist | 103T00000X |
Addresses
Primary practice location
300 Prison Rd
Represa, CA 95671-9529
Mailing address
300 Prison Rd
Represa, CA 95671-3001
Phone (831) 678-5500
Other providers in Represa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 25, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.