Individual
PUJA JAITLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
3016 W CHARLESTON BLVD STE 150, LAS VEGAS, NV 89102-1964
(414) 737-6500
Mailing address
6043 HOLLYWOOD BLVD, LOS ANGELES, CA 90028-5411
(818) 850-6562
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY0840
NV
Other
Enumeration date
11/18/2013
Last updated
07/27/2020
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