Provider Demographics
NPI:1922275635
Name:POPEK, PAULENE B
Entity Type:Individual
Prefix:DR
First Name:PAULENE
Middle Name:B
Last Name:POPEK
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:PAULENE
Other - Middle Name:B
Other - Last Name:POPEK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:10950 SARBONNE LN
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-2234
Mailing Address - Country:US
Mailing Address - Phone:310-472-2061
Mailing Address - Fax:310-472-7563
Practice Address - Street 1:10950 SARBONNE LN
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90077-2234
Practice Address - Country:US
Practice Address - Phone:310-472-2061
Practice Address - Fax:310-472-7563
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY10386102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst