Search › California › 1041C0700X
Dmitriy Puchkarev, ASW
NPI 1215537121 · on the registry since 2020 · sole proprietor
Practice
- Address
- 503 Ocean Front Walk
Venice, CA 90291 - Phone
- (310) 392-3070
- Fax
- (310) 452-8766
- Organisation at this address
- Phoenix Houses Of Los Angeles, Inc.
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 78
Additional practice sites
- 10943 National Blvd Apt 6, Los Angeles, CA
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Also registered as
- 101YA0400X
390200000X - Licence states on file
- CA, NULL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2025-08-04
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California