Provider Demographics
NPI:1245785609
Name:PUGA, DARIO JOSE (LMFT)
Entity type:Individual
Prefix:MR
First Name:DARIO
Middle Name:JOSE
Last Name:PUGA
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 1:7200 BANCROFT AVE STE 133
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605-2480
Mailing Address - Country:US
Mailing Address - Phone:408-918-2618
Mailing Address - Fax:408-579-6143
Practice Address - Street 1:7200 BANCROFT AVE STE 133
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-2480
Practice Address - Country:US
Practice Address - Phone:510-553-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-16
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA114540106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist