Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist |
NPI | 1063980720 |
---|---|
Provider Name | Dr. Al Pappalardo |
First Address | Anaheim, CA 92807-2522 |
Second Address | Anaheim, CA 92807-2522 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2018 |
Last Update Date | 10/11/2018 |