Individual
KENNETH PUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPT
Contact information
Practice address
2150 STOCKTON BLVD, SACRAMENTO, CA 95817-1337
(916) 875-1000
(916) 875-1006
Mailing address
2150 STOCKTON BLVD, SACRAMENTO, CA 95817-1337
(916) 875-1000
(916) 875-1006
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT26022
CA
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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