Provider Demographics
NPI:1558402099
Name:JAKLE, KATHERINE (PSYD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:JAKLE
Suffix:
Gender:F
Credentials:PSYD
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1328 WESTWOOD BLVD STE 10
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-4932
Mailing Address - Country:US
Mailing Address - Phone:424-383-5113
Mailing Address - Fax:818-895-9519
Practice Address - Street 1:1000 W CARSON STREET
Practice Address - Street 2:HARBOR UCLA MEDICAL CENTER DEPARTMENT OF PSYCHIATRY
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90509
Practice Address - Country:US
Practice Address - Phone:310-222-1636
Practice Address - Fax:310-328-7217
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA24708103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical