Individual
JEFFREY PAUL PUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ASW
Contact information
Practice address
2245 CHALLENGER WAY, SANTA ROSA, CA 95407-5418
(707) 565-4993
Mailing address
7596 COMMERCE BLVD APT 19, COTATI, CA 94931-3714
(760) 793-0203
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
122229
CA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
01/15/2018
Last updated
08/11/2025
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