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

Katherine Wells Jack

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1912696907

Katherine Wells Jack is an Addiction (Substance Use Disorder) Counselor in Los Angeles, California. Practices as a sole proprietor. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

8831 Venice Blvd
Los Angeles, CA 90034-3223
Phone: (310) 204-5200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X

Record details

NPI number1912696907
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 4, 2023
Last updated in NPPESMay 4, 2023
Certification dateMay 4, 2023

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