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NPI Code Detail

MEDICARE: JANICE GAINES

MEDICARE: JANICE GAINES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLCSW20916CA

General Provider Information

NPI Number : 1528156221
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANICE GAINES
Provider Business Mailing Address
First Line : PO BOX 90733
Second Line :
City : PASADENA
State : CA
Zip : 91109-0733
Country : US
Telephone Number : 818-425-6774
Fax Number :
Provider Business Practice Location Address
First Line : 3101 OCEAN PARK BLVD STE 100
Second Line :
City : SANTA MONICA
State : CA
Zip : 90405-3029
Country : US
Telephone Number : 818-425-6774
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2006
Last Update Date : 02/02/2026

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Directions to “ JANICE GAINES ” Practice Location

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