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General NPI Number Information
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NPI Number | 1710175716
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Entity Type | Individual
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Provider Name | JOSHUA RAY PURGA PSYD
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Gender | Male
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Dates
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Enumeration Date | 10/04/2007
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Last Update Date | 08/01/2010
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Provider Practice Location Address
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Address Line | 430 CRANE AVE SUITE 109
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City | TURLOCK
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State | CA
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Zip | 95380-4551
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Country | US
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Telephone | 714-292-3153
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Fax | 209-667-8611
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Provider Business Mailing Address
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Address Line | 430 CRANE AVE SUITE 109
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City | TURLOCK
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State | CA
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Zip | 95380-4551
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Country | US
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Telephone | 714-292-3153
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Fax | 209-667-8611
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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 | PSY 20453
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License Number State | CA
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