Light, Jack Walter
Light, Jack Walter is an sole proprietor health care provider with primary practice located at 20 Modesto , Irvine CA 92602-0930. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Light, Jack Walter can be contacted via phone (714) 469-2745.Contact Information
Primary practice address
20 Modesto
Irvine CA 92602-0930
Phone: (714) 469-2745
Fax: (714) 731-0176
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | LCSW16241 | California |
Profile Details
| NPI number | 1326143132 |
|---|---|
| LBN Legal business name | Light, Jack Walter |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 14th, 2006 |
| Last updated | Mar 22nd, 2017 - about 8 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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