Individual
DR. GARY STEPHEN PUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2104 SEA RIDGE DR, SIGNAL HILL, CA 90755-3779
(562) 599-0865
Mailing address
2104 SEA RIDGE DR, SIGNAL HILL, CA 90755-3779
(562) 599-0865
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY 13517
CA
Other
Enumeration date
01/23/2012
Last updated
01/23/2012
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