Healthcare Provider Details

I. General information

NPI: 1851236350
Provider Name (Legal Business Name): JENNIFER MARIA BULGER PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 PICO BLVD APT 706
SANTA MONICA CA
90405-1836
US

IV. Provider business mailing address

PO BOX 1320
SANTA MONICA CA
90406-1320
US

V. Phone/Fax

Practice location:
  • Phone: 760-815-0623
  • Fax:
Mailing address:
  • Phone: 760-815-0623
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number32655
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: