Provider Demographics
NPI:1376083030
Name:BUGGA-BOO, LLC
Entity Type:Organization
Organization Name:BUGGA-BOO, LLC
Other - Org Name:LICE CLINICS OF AMERICA - TEMECULA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-625-5580
Mailing Address - Street 1:2438 BEAR ROCK GLN
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92026-5043
Mailing Address - Country:US
Mailing Address - Phone:760-625-5580
Mailing Address - Fax:
Practice Address - Street 1:41715 ENTERPRISE CIR N
Practice Address - Street 2:STE 209
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-5663
Practice Address - Country:US
Practice Address - Phone:951-286-5958
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty