Lea Dupirak | Santa Rosa, CA • PECOS Search

Lea Dupirak

Counselor

Behavioral Health & Social Service Providers

1710 Mendocino Ave, Santa Rosa, CA 95401-4317

(707) 571-2215 (415) 320-0698

PECOS Enrollment

Based on the most recent information from CMS, provider Lea Dupirak does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1215163399
Provider Type
Individual
Full Name
Dupirak, Lea
Gender
Female

Sole Proprietor
Yes
Enumeration Date
6/3/2009
Last Updated
6/3/2009

Contact Information

Practice Location

1710 Mendocino Ave, Santa Rosa, CA 95401-4317

Unlisted Fax

Mailing Location

1955 Center Rd, Novato, CA 94947-2955

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YA0400X Primary	Description Counselor Behavioral Health & Social Service Providers	License RI-D0905181000 California