Doctor Name: | MR. SIMON PUENTE |
NPI Number: | 1467791731 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MSW |
License Number: | 35277 |
Business Practice Address: | 24863 W Jayne Ave Coalinga, CA - 932109502 |
Business Phone Number: | 5599354900 |
Business Fax Number: | |
Mailing Address: | 5317 N Hazel Ave, FRESNO |
State: | CA |
Postal Code: | 937112614 |
Phone Number: | 5593124068 |
Fax Number: | |
NPI Enumeration Date: | 02/06/2013 |
NPI Last Update Date: | 02/06/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 35277 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |