Individual ProviderBeverly TrunkMarriage & Family TherapistBehavioral Health & Social Service ProvidersPractice Address2730 Wilshire Blvd, Suite 630, Santa Monica, CA 90403-4743(310) 453-1450PECOS EnrollmentBased on the most recent information from CMS, provider Beverly Trunk does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1659597250Provider TypeIndividualFull NameTrunk, BeverlyTitleDr.GenderFemaleSole ProprietorYesEnumeration Date4/18/2007Last Updated7/8/2007Contact InformationPractice LocationPractice Address2730 Wilshire Blvd, Suite 630, Santa Monica, CA 90403-4743Phone(310) 453-1450FaxUnlisted FaxMailing LocationMailing Address2730 Wilshire Blvd, Suite 630, Santa Monica, CA 90403-4743PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106H00000XPrimaryDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicenseMFC38548California