Provider Demographics
NPI:1982808242
Name:PALIANI, RICHARD EMILIO (MED)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:EMILIO
Last Name:PALIANI
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4712 ADMIRALTY WAY
Mailing Address - Street 2:731
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-6905
Mailing Address - Country:US
Mailing Address - Phone:310-915-4515
Mailing Address - Fax:
Practice Address - Street 1:4712 ADMIRALTY WAY
Practice Address - Street 2:731
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-6905
Practice Address - Country:US
Practice Address - Phone:310-915-4515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT29197106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist