Provider Demographics
NPI:1790075455
Name:PULS, RICHARD WILLIAM (LMFT)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:WILLIAM
Last Name:PULS
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 ALDER LN
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-3345
Mailing Address - Country:US
Mailing Address - Phone:714-826-1680
Mailing Address - Fax:
Practice Address - Street 1:151 N KRAEMER BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-5002
Practice Address - Country:US
Practice Address - Phone:714-394-7964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-15
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC33912106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist