Provider Demographics
NPI:1588328462
Name:PALOGAN, JAMAICA GARCIA
Entity type:Individual
Prefix:
First Name:JAMAICA
Middle Name:GARCIA
Last Name:PALOGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JAMAICA
Other - Middle Name:GARCIA
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18592 WOODWIND LN
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-1108
Mailing Address - Country:US
Mailing Address - Phone:714-716-7727
Mailing Address - Fax:
Practice Address - Street 1:1100 W STEWART DR
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3891
Practice Address - Country:US
Practice Address - Phone:714-771-8134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95088206163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health