Provider Demographics
NPI:1205477494
Name:LEPE, JEANETTE (MS)
Entity type:Individual
Prefix:
First Name:JEANETTE
Middle Name:
Last Name:LEPE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3737 ACORDE AVE
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-2572
Mailing Address - Country:US
Mailing Address - Phone:818-294-2004
Mailing Address - Fax:
Practice Address - Street 1:624 COMMERCE AVE
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-3883
Practice Address - Country:US
Practice Address - Phone:661-942-9135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-30
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst