Provider Demographics
NPI:1790946309
Name:PALLUGNA, ANTONETTE S
Entity Type:Individual
Prefix:MRS
First Name:ANTONETTE
Middle Name:S
Last Name:PALLUGNA
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 1:736 E MERCED AVE
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-5142
Mailing Address - Country:US
Mailing Address - Phone:626-917-0045
Mailing Address - Fax:626-917-3810
Practice Address - Street 1:736 E MERCED AVE
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-5142
Practice Address - Country:US
Practice Address - Phone:626-917-0045
Practice Address - Fax:626-917-3810
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA197606628372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion