Basic Information
| Provider Information | |||||||||
| NPI: | 1538557384 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PUGLIANI | ||||||||
| FirstName: | GLENDA | ||||||||
| MiddleName: | JANE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | COTA/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8338 FOXFIRE DR | ||||||||
| Address2: | |||||||||
| City: | ORANGEVALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956623813 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167573937 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2540 CARMICHAEL WAY | ||||||||
| Address2: | |||||||||
| City: | CARMICHAEL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956085314 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9164820465 | ||||||||
| FaxNumber: | 9164878623 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/02/2015 | ||||||||
| LastUpdateDate: | 01/02/2015 | ||||||||
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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 | 225X00000X | OTA30 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.