Provider Demographics
NPI:1609608728
Name:PALOMINO, ALMA
Entity type:Individual
Prefix:
First Name:ALMA
Middle Name:
Last Name:PALOMINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 S 8TH ST STE B3
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-3236
Mailing Address - Country:US
Mailing Address - Phone:760-353-6571
Mailing Address - Fax:760-353-6571
Practice Address - Street 1:444 S 8TH ST STE B3
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-3236
Practice Address - Country:US
Practice Address - Phone:760-353-6571
Practice Address - Fax:760-353-6571
Is Sole Proprietor?:No
Enumeration Date:2024-08-16
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
CAC5BF0305S24002172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator