Healthcare Provider Details

I. General information

NPI: 1508599663
Provider Name (Legal Business Name): ELIZABETH JENNIFER PUELS PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH JENNIFER SOTO

II. Dates (important events)

Enumeration Date: 07/06/2022
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8500 WILSHIRE BLVD STE 103
BEVERLY HILLS CA
90211-3110
US

IV. Provider business mailing address

11150 W OLYMPIC BLVD STE 780
LOS ANGELES CA
90064-1829
US

V. Phone/Fax

Practice location:
  • Phone: 424-738-1993
  • Fax:
Mailing address:
  • Phone: 213-721-1571
  • Fax: 213-721-1578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95021337
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: