Anderson, Jack Glenn

Anderson, Jack Glenn is an individual health care provider with primary practice located at 200 E Del Mar Blvd Suite 122, Pasadena CA 91105-2544. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Anderson, Jack Glenn can be contacted via phone (626) 792-8922.

Contact Information

Primary practice address
200 E Del Mar Blvd Suite 122 Pasadena CA 91105-2544
Phone: (626) 792-8922
Fax: (626) 792-6504
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY10819 California

Profile Details

NPI number 1134330947
LBN Legal business name Anderson, Jack Glenn
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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