Provider Demographics
NPI:1083365233
Name:PUGA-AREVALO, GABRIELA ARACELI
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:ARACELI
Last Name:PUGA-AREVALO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1536 POPPY LN
Mailing Address - Street 2:
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93446-4306
Mailing Address - Country:US
Mailing Address - Phone:805-975-9075
Mailing Address - Fax:
Practice Address - Street 1:6850 MORRO RD
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-4123
Practice Address - Country:US
Practice Address - Phone:805-434-2449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health