Provider Demographics
NPI:1508121476
Name:POUESI, JUNE V
Entity Type:Individual
Prefix:
First Name:JUNE
Middle Name:V
Last Name:POUESI
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 1:20715 AVALON BLVD
Mailing Address - Street 2:SUITE #200
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-3317
Mailing Address - Country:US
Mailing Address - Phone:310-538-0555
Mailing Address - Fax:310-538-1960
Practice Address - Street 1:998399 OTTOVILLE TAFUNA
Practice Address - Street 2:
Practice Address - City:PAGO PAGO
Practice Address - State:AMERICAN SAMOA
Practice Address - Zip Code:96799
Practice Address - Country:UM
Practice Address - Phone:684-699-0891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-06
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator