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General NPI Number Information
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NPI Number | 1114113149
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Entity Type | Individual
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Provider Name | KATHLEEN MARIE PULEO PSY.D
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Gender | Female
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Dates
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Enumeration Date | 09/24/2007
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Last Update Date | 06/17/2009
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Provider Practice Location Address
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Address Line | 66 HURLBUT ST
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City | PASADENA
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State | CA
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Zip | 91105-4025
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Country | US
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Telephone | 626-441-4221
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Fax |
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Provider Business Mailing Address
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Address Line | 18825 NAU AVE
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City | PORTER RANCH
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State | CA
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Zip | 91326
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Country | US
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Telephone | 818-360-1663
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY22642
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License Number State | CA
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