Active NPI
Debra Lee Poorman
- Addiction (Substance Use Disorder) Counselor
- Santa Monica, CA
National Provider Identifier
1043596612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 01-093276
- Practice address
- 909 Pico Blvd
Santa Monica, CA 90405-1326 - Phone
- (310) 614-6200
- Fax
- (310) 450-2024
- NPI assigned
- Oct 27, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 01-093276 | CA | Primary |
Addresses
Primary practice location
909 Pico Blvd
Santa Monica, CA 90405-1326
Mailing address
909 Pico Blvd
Santa Monica, CA 90405-1326
Phone (310) 614-6200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01-093276 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319673600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319673600000",
"number": "1043596612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "909 PICO BLVD",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904051326",
"telephone_number": "310-614-6200",
"fax_number": "310-450-2024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "909 PICO BLVD",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904051326",
"telephone_number": "310-614-6200",
"fax_number": "310-450-2024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POORMAN",
"first_name": "DEBRA",
"middle_name": "LEE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-27",
"last_updated": "2011-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "01-093276",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.