Healthcare Provider Details

I. General information

NPI: 1003725649
Provider Name (Legal Business Name): DIONICIA BUGARIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

791 S 4TH AVE
YUMA AZ
85364-3067
US

IV. Provider business mailing address

791 S 4TH AVE
YUMA AZ
85364-3067
US

V. Phone/Fax

Practice location:
  • Phone: 928-783-3616
  • Fax: 520-300-8012
Mailing address:
  • Phone: 928-783-3616
  • Fax: 520-300-8012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC-24962
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: