Wasserman, Jack Saul

Wasserman, Jack Saul is an sole proprietor health care provider with primary practice located at 1101 Dove St , Newport Beach CA 92660-2839. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Wasserman, Jack Saul can be contacted via phone (714) 812-6869.

Contact Information

Primary practice address
1101 Dove St Newport Beach CA 92660-2839
Phone: (714) 812-6869
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 103TA0400X PSY11898 California
Behavioral Health & Social Service Providers / Clinical 103TC0700X 11898 California

Profile Details

NPI number 1225134893
LBN Legal business name Wasserman, Jack Saul
Credentials PH.D
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 14th, 2006
Last updated Jan 22nd, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1225134893 NPPES
California Other 1225134893 103TA0400X

Popular Providers