Provider Demographics
NPI:1558426791
Name:CHENG, PUIHAR
Entity Type:Individual
Prefix:
First Name:PUIHAR
Middle Name:
Last Name:CHENG
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 1:34730 BOB WILSON DR
Mailing Address - Street 2:BLDG3 SUITE101
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92134-3098
Mailing Address - Country:US
Mailing Address - Phone:619-532-5084
Mailing Address - Fax:619-532-7354
Practice Address - Street 1:34730 BOB WILSON DR
Practice Address - Street 2:BLDG3 SUITE101
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92134-3098
Practice Address - Country:US
Practice Address - Phone:619-532-5084
Practice Address - Fax:619-532-7354
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI7881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical