Jacquelyn Poper | Santa Monica, CA • PECOS Search

Jacquelyn Poper

Marriage & Family Therapist

Behavioral Health & Social Service Providers

3201 Wilshire Blvd, Suite 310, Santa Monica, CA 90403-2344

PECOS Enrollment

Based on the most recent information from CMS, provider Jacquelyn Poper does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1992250476
Provider Type
Individual
Full Name
Poper, Jacquelyn
Credential
LMFT

Gender
Female
Sole Proprietor
Yes
Enumeration Date
8/24/2016
Last Updated
8/24/2016

Contact Information

Practice Location

3201 Wilshire Blvd, Suite 310, Santa Monica, CA 90403-2344

Unlisted Fax

Mailing Location

3201 Wilshire Blvd, Suite 310, Santa Monica, CA 90403-2344

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 106H00000X Primary	Description Marriage & Family Therapist Behavioral Health & Social Service Providers	License 93171 California