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DR. CAROL GOTTUSO JAENICKE PH.D.
NPI 1194917625
Psychologist - Clinical in Los Angeles, CA

Active since August 17, 2007
12304 SANTA MONICA BLVD, STE. 211, LOS ANGELES, CA 90025(323) 936-5718(323) 936-5718 Get Directions Write a Review

NPPES record last updated: August 17, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Carol Gottuso Jaenicke Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. CAROL GOTTUSO JAENICKE PH.D. (NPI 1194917625) is an individual clinical provider in Los Angeles, California, licensed in California (PSY9677) and active in the NPI registry since August 2007.

NPPES Registry Identity

NPI1194917625
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. CAROL GOTTUSO JAENICKECredential: PH.D.
Location Address12304 SANTA MONICA BLVD, STE. 211Los Angeles, CA 90025-2551
Mailing Address12304 Santa Monica Blvd, Ste. 211Los Angeles, CA 90025-2551 · (323) 936-5718 · Fax (323) 936-5718
Phone(323) 936-5718
Fax(323) 936-5718
Sole ProprietorYes
Enumeration DateAugust 17, 2007
✔ NPI 1194917625 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in CA · PSY9677
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
12304 SANTA MONICA BLVD, Los Angeles, CA 90025
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. DANIELLE JAGODA LMFT
Marriage & Family Therapist
12304 SANTA MONICA BLVD, SUITE 215
LOS ANGELES, CA 90025
Los Angeles County (310) 569-2302
DR. CARON M LEWIS PH.D.
Psychologist (Clinical)
12304 SANTA MONICA BLVD, SUITE 211
LOS ANGELES, CA 90025
Los Angeles County (310) 207-4774
RICHARD ALAN GOTTFRIED MFT
Counselor
12304 SANTA MONICA BLVD, SUITE 215
LOS ANGELES, CA 90025
Los Angeles County (310) 207-5177
MR. JOHN B CHEBULTZ M.A.
Specialist/Technologist
12304 SANTA MONICA BLVD, SUITE 300
W LOS ANGELES, CA 90025
Los Angeles County (310) 288-1650
JANICE STIMSON PSY.D., R.A.S.
Psychologist (Cognitive & Behavioral)
12304 SANTA MONICA BLVD, SUITE 200
WEST LOS ANGELES, CA 90025
Los Angeles County (310) 207-4322
BARBARA EILEEN MAY MBA, MA
Marriage & Family Therapist
12304 SANTA MONICA BLVD, SUITE 315
LOS ANGELES, CA 90025
Los Angeles County (424) 888-2757
MS. SABA HAROUNI
Marriage & Family Therapist
12304 SANTA MONICA BLVD, SUITE 327
LOS ANGELES, CA 90025
Los Angeles County (323) 388-5578
DEBORAH SHAMTOUB RBT
Behavior Technician
12304 SANTA MONICA BLVD
LOS ANGELES, CA 90025
Los Angeles County (310) 926-5753

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carol Jaenicke's NPI number?

The NPI number for Carol Jaenicke is 1194917625. It was assigned to this individual provider in the NPPES registry on August 17, 2007.

Where is Carol Jaenicke located?

Carol Jaenicke practices at 12304 Santa Monica Blvd Ste. 211, Los Angeles, CA 90025. The listed phone number is (323) 936-5718.

What is Carol Jaenicke's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Carol Jaenicke was last updated on August 17, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.