Provider Demographics
NPI:1164558938
Name:PUSZTAI, JOHN LOUIS (MA , MFT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:LOUIS
Last Name:PUSZTAI
Suffix:
Gender:M
Credentials:MA , MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:871 DELTA PL
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-3607
Mailing Address - Country:US
Mailing Address - Phone:909-621-1288
Mailing Address - Fax:909-482-2211
Practice Address - Street 1:250 W 1ST ST
Practice Address - Street 2:SUITE 242
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-4736
Practice Address - Country:US
Practice Address - Phone:909-457-7265
Practice Address - Fax:909-482-2211
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC15568106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist