Basic Information
| Provider Information | |||||||||
| NPI: | 1558402099 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JAKLE | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | |||||||||
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| Credential: | PSY.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1328 WESTWOOD BLVD STE 10 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900244932 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4243835113 | ||||||||
| FaxNumber: | 8188959519 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 W CARSON STREET | ||||||||
| Address2: | HARBOR UCLA MEDICAL CENTER DEPARTMENT OF PSYCHIATRY | ||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102221636 | ||||||||
| FaxNumber: | 3103287217 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2007 | ||||||||
| LastUpdateDate: | 02/25/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/25/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 24708 | CA | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.