Individual provider · NPI-1
Nicole Pufahl
Student in an Organized Health Care Education/Training Program · Moorpark, CA
NPI number1083179501
StatusActive
Last updated in NPPESFeb 8, 2019
Details
- NPI
- 1083179501
- Entity type
- Individual (NPI-1)
- Name
- Nicole Pufahl
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 8, 2019
- Last updated
- Feb 8, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
| 2255A2300X | Specialist/Technologist, Athletic Trainer | – | – |
Practice location
6925 Hogan StMoorpark, CA 93021-8736
Phone 805-587-2772
Mailing address
6925 Hogan StMoorpark, CA 93021-8736
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