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JACK WARREN ITO PHD
NPI 1710966593
Psychologist - Clinical in 29 Palms, CA

Active since January 11, 2006
NAVAL HOSPITAL 29 PALMS, MCAGCC, 29 PALMS, CA 92278(760) 830-2782 Get Directions Write a Review

NPPES record last updated: November 1, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jack Warren Ito Phd NPPES

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

JACK WARREN ITO PHD (NPI 1710966593) is an individual clinical provider in 29 Palms, California, licensed in Pennsylvania (PS008530L) and active in the NPI registry since January 2006.

NPPES Registry Identity

NPI1710966593
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameJACK WARREN ITOCredential: PHD
Location AddressNAVAL HOSPITAL 29 PALMS, MCAGCC29 Palms, CA 92278
Mailing AddressPo Box 6329 Palms, CA 92277 · (760) 830-2782 · Fax (724) 407-1201
Phone(760) 830-2782
Sole ProprietorNo
Enumeration DateJanuary 11, 2006
Last NPPES UpdateNovember 1, 2007
✔ NPI 1710966593 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in PA · PS008530L
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.
Also ListedPsychologistTaxonomy 103T00000X · License PS008530L (PA)
NAVAL HOSPITAL 29 PALMS, 29 Palms, CA 92278
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Other Names 1

Former Name (1)Todd Warren Martin Phd

Other Identifiers 6

Medicare UPINMA959098PA
Medicaid016536380004PA
Medicare ID-Type UnspecifiedMA959098PA
Other959098PA · Highmark Provider Number
OtherA771081PA · Value Behavioral Health
Other163751PA · Value Behavioral Health

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 Ito's NPI number?

The NPI number for Jack Ito is 1710966593. It was assigned to this individual provider in the NPPES registry on January 11, 2006. The provider is also known as Todd Warren Martin Phd.

Where is Jack Ito located?

Jack Ito practices at Naval Hospital 29 Palms Mcagcc, 29 Palms, CA 92278. The listed phone number is (760) 830-2782.

What is Jack Ito'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 Jack Ito was last updated on November 1, 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.