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General NPI Number Information
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NPI Number | 1619281003
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Entity Type | Organization
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Legal Business Name | JEROME TEPPERMAN PSYCHOLOGY CORP
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Dates
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Enumeration Date | 07/28/2010
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Last Update Date | 07/28/2010
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Provider Practice Location Address
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Address Line | 3921 WILSHIRE BLVD SUITE 200
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City | LOS ANGELES
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State | CA
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Zip | 90010-3317
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Country | US
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Telephone | 213-385-2341
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Fax |
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Provider Business Mailing Address
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Address Line | 171 N CHURCH LN #404
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City | LOS ANGELES
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State | CA
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Zip | 90049-2000
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Country | US
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Telephone | 213-385-2341
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEROME HARVEY TEPPERMAN
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Credential | PHD
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Telephone | 213-385-2341
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | PSY5311
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License Number State | CA
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