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NPI Code Detail

MEDICARE: MS. STEPHANY PULIDO

MEDICARE:  MS. STEPHANY  PULIDO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1659889608
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. STEPHANY PULIDO
Provider Business Mailing Address
First Line : 351 E BRADLEY AVE
Second Line :
City : EL CAJON
State : CA
Zip : 92021-2917
Country : US
Telephone Number : 619-569-7440
Fax Number :
Provider Business Practice Location Address
First Line : 8001 PALM ST
Second Line :
City : LEMON GROVE
State : CA
Zip : 91945-3026
Country : US
Telephone Number : 619-843-6579
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2018
Last Update Date : 01/11/2018

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Directions to “ MS. STEPHANY PULIDO ” Practice Location

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