Most Relevant Information
Provider Data
| NPI Number: | 1003544255 |
| Provider Name: | NICOLE PUGA |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 90047 |
Most Important Dates
| Enumeration Date: | 08/15/2022 |
| Last Updated: | 08/15/2022 |
Provider Practice Location
5717 E BEVERLY BLVD
LOS ANGELES
CA
900222823
Practice Location Phone/Fax
| Phone: | 3234304200 |
| Fax: |
Provider Mailing Location
4718 E 59TH PL
MAYWOOD
CA
902703302
Provider Mailing Phone/Fax
| Phone: | 3233488302 |
| Fax: |