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NPI Code Detail

MEDICARE: LUCILLE I SIPERT

MEDICARE: LUCILLE I SIPERT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator
2172V00000XCommunity Health Worker
3101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1619238920
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUCILLE I SIPERT
Provider Business Mailing Address
First Line : 1328 2ND ST
Second Line :
City : SANTA MONICA
State : CA
Zip : 90401-1122
Country : US
Telephone Number : 310-394-6889
Fax Number :
Provider Business Practice Location Address
First Line : 844 PICO BLVD
Second Line :
City : SANTA MONICA
State : CA
Zip : 90405-1325
Country : US
Telephone Number : 310-314-6200
Fax Number : 310-450-2024
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2012
Last Update Date : 10/23/2018

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Directions to “ LUCILLE I SIPERT ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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