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Individual
DR. JACK SAUL WASSERMAN
Active
Individual
DR. JACK SAUL WASSERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
PSY11898
CA
103TC0700X
Clinical Psychologist
Primary
11898
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225134893
103TA0400X
CA
Enumeration date
09/14/2006
Last updated
01/22/2019
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