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MR. JACK R WAITES III
NPI 1407629777
Counselor - Addiction (Substance Use Disorder) in Los Angeles, CA

Active since October 30, 2023
155 BIMINI PL, LOS ANGELES, CA 90004(213) 388-5423 Get Directions Write a Review

NPPES record last updated: October 30, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. Jack R Waites Iii NPPES

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

MR. JACK R WAITES III (NPI 1407629777) is an individual addiction (substance use disorder) provider in Los Angeles, California and active in the NPI registry since October 2023.

NPPES Registry Identity

NPI1407629777
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameMR. JACK R WAITES III
Location Address155 BIMINI PLLos Angeles, CA 90004-5902
Mailing Address155 Bimini PlLos Angeles, CA 90004-5902 · (213) 388-5423
Phone(213) 388-5423
Sole ProprietorNo
Enumeration DateOctober 30, 2023
NPPES CertifiedOctober 30, 2023
✔ NPI 1407629777 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
155 BIMINI PL, Los Angeles, CA 90004
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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.

JESSICA ANGELA SOLIS SUDCR#16758
Counselor (Addiction (Substance Use Disorder))
155 BIMINI PL
LOS ANGELES, CA 90004
Los Angeles County (213) 388-5423
ELDA NALLELI ROCHA
Counselor (Addiction (Substance Use Disorder))
155 BIMINI PL
LOS ANGELES, CA 90004
Los Angeles County (213) 388-5423
AMANDA LAFFERRE
Counselor (Addiction (Substance Use Disorder))
155 BIMINI PL
LOS ANGELES, CA 90004
Los Angeles County (213) 388-5423
EFREM LOUIS REED
Counselor (Addiction (Substance Use Disorder))
155 BIMINI PL
LOS ANGELES, CA 90004
Los Angeles County (213) 388-5423
ADRIAN ENRIQUE CACERES
Counselor (Addiction (Substance Use Disorder))
155 BIMINI PL
LOS ANGELES, CA 90004
Los Angeles County (213) 281-1408
ADRIAN STEPHEN PARDO
Counselor (Addiction (Substance Use Disorder))
155 BIMINI PL
LOS ANGELES, CA 90004
Los Angeles County (213) 388-5423
SAUL CAMPOS
Counselor (Addiction (Substance Use Disorder))
155 BIMINI PL
LOS ANGELES, CA 90004
Los Angeles County (213) 388-5423
RILIND MCNAMARA
Counselor (Addiction (Substance Use Disorder))
155 BIMINI PL
LOS ANGELES, CA 90004
Los Angeles County (213) 388-5423

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 Jack Waites's NPI number?

The NPI number for Jack Waites is 1407629777. It was assigned to this individual provider in the NPPES registry on October 30, 2023.

Where is Jack Waites located?

Jack Waites practices at 155 Bimini Pl, Los Angeles, CA 90004. The listed phone number is (213) 388-5423.

What is Jack Waites's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Jack Waites was last updated on October 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.