JACK GAINES A PROFESSIONAL CORP. NPI 1619210291

NPI Information

NPI: 1619210291
Provider Name: JACK GAINES A PROFESSIONAL CORP.
Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

Address:
4833 RUBIO AVE
ENCINO, CA
ZIP 91436
Phone: (818) 981-4030
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JACK GAINES A PROFESSIONAL CORP. is an adult mental health clinic center in Encino, CA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. JACK GAINES A PROFESSIONAL CORP. NPI is 1619210291. The provider is registered as an organization entity type.

The provider's business location address is:

4833 RUBIO AVE
ENCINO, CA
ZIP 91436-118
Phone: (818) 981-4030

The provider's authorized official is Jack W. Gaines .
The authorized official title is President and has the following contact phone number (818) 981-4030.

The enumeration date for this NPI number is 4/1/2013 and was last updated on 4/1/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0850X	Clinic/Center	Adult Mental Health	C14269	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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