Jacqueline B Pepper, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY6102 Issued in FL

Practice address

1515 N University Dr
Suite 202
Coral Springs, FL 33071-6096

Phone

(954) 345-2292

Fax

(954) 341-8101

NPI assigned

Feb 5, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473724800000",
    "number": "1114066461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 N UNIVERSITY DR",
            "address_2": "STE 203",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330718919",
            "telephone_number": "954-345-2292",
            "fax_number": "954-341-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 N UNIVERSITY DR",
            "address_2": "SUITE 202",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330716096",
            "telephone_number": "954-345-2292",
            "fax_number": "954-341-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEPPER",
        "first_name": "JACQUELINE",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2016-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY6102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS NUMBER",
            "identifier": "54571",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dany Pena
• Maria Luisa Pena, DDS
• Maria Elena Penades, IBLCE
• Israel E Penate, M.D
• Peniel Home Care LLC
• Jessica L Perciak, SLP.D., CCC-SLP
• Maria Soledad Perea Barbosa, M.D.
• Djalma Pereira
• Vanessa Pereyra
• Katherine Perez Burgos, M.D.

• Clinical Psychologist in Coral Springs, FL
• Providers in Coral Springs, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.