DR. JERITT ROSS TUCKER


Address: 700 S Flower St Ste 1000, Los Angeles, CA 90017-4112
Phone: 2136006096

DR. JERITT ROSS TUCKER (NPI# 1689068264) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1689068264
Entity Type Individual
Full Name DR. JERITT ROSS TUCKER
Credential PHD
Practice Address 700 S Flower St Ste 1000
Los Angeles
CA 90017-4112
Practice Telephone 2136006096
Mailing Telephone 2136006096
Mailing Fax Number 6176653449
Enumeration Date 2015-03-23
Last Update Date 2019-11-19
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 103TC1900X Psychologist
Specialization: Counseling
083818 IA Behavioral Health & Social Service Providers
Y 103TC1900X Psychologist
Specialization: Counseling
31412 CA Behavioral Health & Social Service Providers

Office Location

Street Address 700 S FLOWER ST STE 1000
City LOS ANGELES
State CA
Zip Code 90017-4112

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Taxonomy Information

Taxonomy Code 103TC1900X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Counseling

Taxonomy Definition

Definition to come...

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Competitor

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City LOS ANGELES
Zip Code 90017

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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