Healthcare Provider Details

I. General information

NPI: 1265552483
Provider Name (Legal Business Name): PUJA CHHABRA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 06/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 AVENUE 64
PASADENA CA
91105-2711
US

IV. Provider business mailing address

500 E OLIVE AVE STE 540
BURBANK CA
91501-2132
US

V. Phone/Fax

Practice location:
  • Phone: 323-254-2274
  • Fax:
Mailing address:
  • Phone: 818-466-2522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS24159
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: