Basic Information
| Provider Information | |||||||||
| NPI: | 1265552483 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHHABRA | ||||||||
| FirstName: | PUJA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 E OLIVE AVE | ||||||||
| Address2: | STE 540 | ||||||||
| City: | BURBANK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 915012132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8184662522 | ||||||||
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| Practice Location | |||||||||
| Address1: | 940 AVENUE 64 | ||||||||
| Address2: | |||||||||
| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 911052711 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3232542274 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2007 | ||||||||
| LastUpdateDate: | 06/20/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LCS24159 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.