Provider Demographics
NPI:1992056394
Name:PUGLIESE, SUZANNE (MA, LMFT)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:PUGLIESE
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:882 REINMAN CT
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:CA
Mailing Address - Zip Code:95361-4508
Mailing Address - Country:US
Mailing Address - Phone:209-408-6545
Mailing Address - Fax:
Practice Address - Street 1:1351 GEER RD STE 107
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380-3269
Practice Address - Country:US
Practice Address - Phone:209-633-3067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-25
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA129342106H00000X
CA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist