Provider Demographics
NPI:1265940464
Name:PUGA, FRANCISCO JAVIER JR
Entity type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:JAVIER
Last Name:PUGA
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2758 RIDGEWAY DR
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-7738
Mailing Address - Country:US
Mailing Address - Phone:619-259-1259
Mailing Address - Fax:
Practice Address - Street 1:3934 MURPHY CANYON RD STE B202
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4437
Practice Address - Country:US
Practice Address - Phone:619-281-6067
Practice Address - Fax:619-924-7080
Is Sole Proprietor?:No
Enumeration Date:2018-01-22
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARBT-17-33624106S00000X
CA1-24-74795103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician