Individual provider · Type 1 NPI

Carol Gottuso Jaenicke, PhD

Clinical Psychologist · Los Angeles, CA

NPI number 1194917625 Active

Practice location

12304 Santa Monica Blvd, Ste. 211
Los Angeles, CA 90025-2551

Call (323) 936-5718 Map

Fax (323) 936-5718

Specialties and licenses

TaxonomyCodeLicense
Clinical Psychologist Primary 103TC0700XPSY9677 (CA)

Clinical Psychologist: 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 discip…

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About NPI 1194917625

Carol Gottuso Jaenicke, PhD's National Provider Identifier is 1194917625, issued on Aug 17, 2007. The primary taxonomy on file is Clinical Psychologist (103TC0700X), and the practice location is in Los Angeles, CA. The record was last updated on Aug 17, 2007.