Provider Demographics
NPI:1114583796
Name:WERKSMAN, JERRI L
Entity Type:Individual
Prefix:
First Name:JERRI
Middle Name:L
Last Name:WERKSMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 N SWALL DR APT AB
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2017
Mailing Address - Country:US
Mailing Address - Phone:954-557-7076
Mailing Address - Fax:
Practice Address - Street 1:9014 BURTON WAY
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1618
Practice Address - Country:US
Practice Address - Phone:888-494-7788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-19
Last Update Date:2019-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst