| Jack Warren Ito, PHD | |
|
Naval Hospital 29 Palms, Mcagcc, 29 Palms, CA 92278 | |
| (760) 830-2782 | |
| Not Available |
| Full Name | Jack Warren Ito |
|---|---|
| Gender | Male |
| Speciality | Psychologist - Clinical |
| Location | Naval Hospital 29 Palms, 29 Palms, California |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710966593 | NPI | - | NPPES |
| 016536380004 | Medicaid | PA | |
| 163751 | Other | PA | VALUE BEHAVIORAL HEALTH |
| 959098 | Other | PA | HIGHMARK PROVIDER NUMBER |
| A771081 | Other | PA | VALUE BEHAVIORAL HEALTH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PS008530L (Pennsylvania) | Primary |
| 103T00000X | Psychologist | PS008530L (Pennsylvania) | Secondary |
| Mailing Address | Practice Location Address |
|---|---|
| Jack Warren Ito, PHD Po Box 63, 29 Palms, CA 92277 Ph: (760) 830-2782 | Jack Warren Ito, PHD Naval Hospital 29 Palms, Mcagcc, 29 Palms, CA 92278 Ph: (760) 830-2782 |
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› Verified 1 days ago
Dr. William H Blau, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 6528a Hillside Avenue, 29 Palms, CA 92277 Phone: 760-367-2117 Fax: 760-367-2117 | |
Dr. Leonard Joseph Weston, PH D Psychologist Medicare: Accepting Medicare Assignments Practice Location: 42525 Rancho Mirage Lane, 5682 The Historic Plaza, 29 Palms, CA 92277 Phone: 760-367-0411 Fax: 760-341-1333 |