Provider Demographics
NPI:1053741587
Name:KUGELMANN, BARBARA R (RN)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:R
Last Name:KUGELMANN
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 1:1200 NO. MAIN STREET
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:90701-5273
Mailing Address - Country:US
Mailing Address - Phone:714-480-6660
Mailing Address - Fax:
Practice Address - Street 1:1200 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-3640
Practice Address - Country:US
Practice Address - Phone:714-480-4639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-19
Last Update Date:2017-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARI-K1312191350101YA0400X
CA334794163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty