Diane Puchbauer, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

21870 Issued in CA

Practice address

188 N Euclid Ave
Upland, CA 91786-6083

Phone

(562) 547-0137

Fax

(909) 921-0221

NPI assigned

Nov 24, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1259020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550016000000",
    "number": "1831427293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1570",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917851570",
            "telephone_number": "562-547-0137",
            "fax_number": "909-921-0221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 N EUCLID AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917866083",
            "telephone_number": "562-547-0137",
            "fax_number": "909-921-0221"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 W Bennett Ave Ste 4",
            "address_purpose": "LOCATION",
            "city": "Glendora",
            "state": "CA",
            "postal_code": "917412568",
            "country_code": "US",
            "telephone_number": "562-547-0137",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUCHBAUER",
        "first_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-24",
        "last_updated": "2019-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "CA",
            "license": "PSY21870",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "21870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Provision Healthcare Services
• Aimee Provost
• Ashley D. Prueitt, PSYD
• Psalm71:9 LLC
• Psychotherapy Solutions
• Allen Lee Puckett, AMFT
• Shanmuga S. Pudunagar Subbiah, MD
• Sara Pugh
• Cassidy Pulice
• Beth Susan Pumerantz, MA, MS, LMFT

• Psychologist in Upland, CA
• Providers in Upland, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.