Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jack Gaines a Professional Corp

Organization Adult Mental Health Clinic/Center · NPI 1619210291

Jack Gaines a Professional Corp is an Adult Mental Health Clinic/Center in Encino, California. Licensed in California. Registered with an NPI since 2013.

Licensed in
CA
In the registry since
2013
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4833 Rubio Ave
Encino, CA 91436-1118
Phone: (818) 981-4030
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Mental Health Clinic/Center (primary) Taxonomy 261QM0850X · Licence C14269 (CA)

Record details

NPI number1619210291
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jack Gaines — President · (818) 981-4030
NPI enumeratedApril 1, 2013
Last updated in NPPESApril 1, 2013
Mailing address4833 Rubio Ave, Encino, CA 91436-1118

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