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JACK GAINES A PROFESSIONAL CORP.
NPI 1619210291
Clinic/Center - Adult Mental Health in Encino, CA

Active since April 01, 2013
4833 RUBIO AVE, ENCINO, CA 91436(818) 981-4030 Get Directions Write a Review

NPPES record last updated: April 1, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jack Gaines A Professional Corp. NPPES

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

JACK GAINES A PROFESSIONAL CORP. (NPI 1619210291) is a healthcare organization registered as an adult mental health in Encino, California and active in the NPI registry since April 2013. The organization lists Jack W. Gaines, President, as its authorized official.

NPPES Registry Identity

NPI1619210291
Entity TypeOrganization
Primary Taxonomy261QM0850X
Legal Business NameJACK GAINES A PROFESSIONAL CORP.
Location Address4833 RUBIO AVEEncino, CA 91436-1118
Mailing Address4833 Rubio AveEncino, CA 91436-1118
Phone(818) 981-4030
Organization SubpartNo
Authorized OfficialJack W. GainesPresident · (818) 981-4030
Enumeration DateApril 1, 2013
✔ NPI 1619210291 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Adult Mental HealthAmbulatory Health Care Facilities
Taxonomy Code261QM0850X
License✔ Licensed in CA · C14269
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
4833 RUBIO AVE, Encino, CA 91436
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Other Providers at the Same Location NPPES

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

DR. SUZANNE DEE ZACHARY PH. D.
Psychologist
4833 RUBIO AVE
ENCINO, CA 91436
Los Angeles County (818) 784-1605

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 Gaines A Professional Corp.'s NPI number?

The NPI number for Jack Gaines A Professional Corp. is 1619210291. It was assigned to this organization in the NPPES registry on April 1, 2013.

Where is Jack Gaines A Professional Corp. located?

Jack Gaines A Professional Corp. is located at 4833 Rubio Ave, Encino, CA 91436. The listed phone number is (818) 981-4030.

What is Jack Gaines A Professional Corp.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adult Mental Health, with taxonomy code 261QM0850X.

When was this NPI record last updated?

The NPPES record for Jack Gaines A Professional Corp. was last updated on April 1, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.