Individual
CHARLIZE PUNO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12395 LEWIS ST STE 202, GARDEN GROVE, CA 92840-4694
(714) 867-6384
Mailing address
8125 FLETCHER GRN, BUENA PARK, CA 90621-1316
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y5428736
DRIVER'S LICENSE
CA
Enumeration date
02/01/2020
Last updated
02/01/2020
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