Provider Demographics
NPI:1144957119
Name:PUCHALSKA, SARA MARIA (RN)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:MARIA
Last Name:PUCHALSKA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1871 SWEETWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-2014
Mailing Address - Country:US
Mailing Address - Phone:415-298-9053
Mailing Address - Fax:
Practice Address - Street 1:1871 SWEETWOOD DR
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2014
Practice Address - Country:US
Practice Address - Phone:415-298-9053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-01
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program