Jacky Pepper, Psy D, Inc

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY6102 Issued in FL

Legal business name

JACKY PEPPER, PSY D, INC

Practice address

1500 N University Dr
Suite 202
Coral Springs, FL 33071-8914

Phone

(954) 345-2292

Fax

(954) 341-8101

NPI assigned

Mar 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jacky Pepper, PSY.D.

Title

Owner

Phone

(954) 232-0044

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354838400000",
    "number": "1841321791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 N UNIVERSITY DR",
            "address_2": "SUITE 202",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330718914",
            "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": "1500 N UNIVERSITY DR",
            "address_2": "SUITE 202",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330718914",
            "telephone_number": "954-345-2292",
            "fax_number": "954-341-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKY PEPPER, PSY D, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2012-12-07",
        "status": "A",
        "authorized_official_last_name": "PEPPER",
        "authorized_official_first_name": "JACKY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-232-0044",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY6102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "54571",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott Mitchell Jablon, DC
• Jacawe Billing Services, Inc.
• Dawn Jackson, PSY.D.
• Latoya Jackson
• Yvonne Elizabeth Jackson
• Besty Jacob, O.D.
• Jerry Jacob, CRNA
• John Jacob, R.PH
• Radu Jacob, MD
• Natalie Jacobs, RMHCI

• 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 Dec 7, 2012; 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.