Jessica Poulsen, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY33753 Issued in CA

Practice address

867 Boylston St FL 5TH-175
Boston, MA 02116-2774

Phone

(508) 203-1521

NPI assigned

Jun 22, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jessica Poulsen, PHD, PC

  • Clinical Psychologist
  • Boston, MA
  • NPI 1164242137
  NPD Authorized official

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

{
    "created_epoch": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1457702276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "867 BOYLSTON ST FL 5TH-175",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021162774",
            "telephone_number": "508-203-1521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "867 BOYLSTON ST FL 5TH-175",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021162774",
            "telephone_number": "508-203-1521"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4421 W Riverside Dr Ste 102",
            "address_purpose": "LOCATION",
            "city": "Burbank",
            "state": "CA",
            "postal_code": "915054051",
            "country_code": "US",
            "telephone_number": "818-699-0907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POULSEN",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-22",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY33753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jean Ernest Kenny Poulard, NP
• Dimitra Pouli, MD, PHD
• Marie-France Poulin
• Sara Poulin
• Gayle Pageau Pouliot, MD, PHD
• Eric Michael Pound, M.D.
• Kerry E Pound, M.D.
• Sarah Parmis Pourali, MD
• Ali Pourvaziri, MD
• Debra D Poutsiaka, MD, PHD

• Clinical Psychologist in Boston, MA
• Providers in Boston, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; 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.