Healthcare Provider Details

I. General information

NPI: 1841128261
Provider Name (Legal Business Name): JARED GASCA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18425 BURBANK BLVD STE 520
TARZANA CA
91356-6687
US

IV. Provider business mailing address

17134 GUNTHER ST
GRANADA HILLS CA
91344-2536
US

V. Phone/Fax

Practice location:
  • Phone: 818-758-2673
  • Fax:
Mailing address:
  • Phone: 818-730-3461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279P1005X
TaxonomyPulmonary Rehabilitation Registered Respiratory Therapist
License Number45244
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: