JACK RYAN (NPI# 1548894207) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548894207 |
| Entity Type | Individual |
| Full Name | JACK RYAN |
| Practice Address |
2137 E Ocean Blvd Long Beach CA 90803-2434 |
| Mailing Address |
2211 E Ocean Blvd Long Beach CA 90803-2440 |
| Practice Telephone | 5624344060 |
| Mailing Telephone | 5624344060 |
| Enumeration Date | 2020-03-02 |
| Last Update Date | 2020-03-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
6473 | CA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2135 E Ocean Blvd, Long Beach, CA 908032434 | 5624344060 | |
| 2211 E Ocean Blvd, Long Beach, CA 908032440 | 5624344060 | |
| 2213 E Ocean Blvd, Long Beach, CA 908032440 | 5624344060 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922252246 | Jack Ryan | Counselor | 2475 Albany Ave Ste 203b, West Hartford, CT 06117-2523 | 2008-11-13 |
| Street Address |
2137 E OCEAN BLVD |
| City | LONG BEACH |
| State | CA |
| Zip Code | 90803-2434 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821400144 | New Found Life, Inc | Substance Abuse Rehabilitation Facility | 2137 E Ocean Blvd, Long Beach, CA 90803-2434 | 2014-05-21 |
| 1386241982 | Alexander Bartosch | Counselor | 2137 E Ocean Blvd, Long Beach, CA 90803-2434 | 2020-10-06 |
| 1053945709 | Joshua Alexander | Counselor | 2137 E Ocean Blvd, Long Beach, CA 90803-2434 | 2020-03-02 |
| 1932733698 | Sean Gray | Counselor | 2137 E Ocean Blvd, Long Beach, CA 90803-2434 | 2020-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568011377 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 6440 E. Pacific Coast Highway, Space B-165, Long Beach, CA 90803 | 2019-09-05 |
| 1518426931 | Quashanika Marin | Behavior Technician | 55555 Anton Blvd, Costa Mesa, CA 90803 | 2019-03-15 |
| 1629569405 | Shiori Koga Lange | Social Worker | 6615 E Pacific Coast Hwy Ste 225, Long Beach, CA 90803 | 2018-05-29 |
| 1083117832 | Amos Hirsh | Specialist/Technologist | 3409 E 1st St., B, Long Beach, CA 90803 | 2018-03-16 |
| 1972029130 | Lilia Bolgov | Dietitian, Registered | 3528 E 2nd St, Apt 1, Long Beach, CA 90803 | 2017-08-19 |
| 1669907523 | Ashley Clary | Substance Abuse Rehabilitation Facility | 6621 Pacific Coast Highway, Long Beach, CA 90803 | 2017-04-27 |
| 1629438247 | Victoria Nguyen Dental Corporation | Dentist | 6437 E. Pacific Coast Highway, Unit A-6, Long Beach, CA 90803 | 2016-02-24 |
| 1548633829 | Anne Yeakel | Chiropractor | 6234 E Pacific Coast Hwy, Unit C, Long Beach, CA 90803 | 2015-11-09 |
| 1376921023 | Lauren Katherine Mills | Registered Nurse | 6000 Bixby Village Drive #5, Long Beach, CA 90803 | 2015-05-14 |
| 1205173317 | Richard Stuart Egan | Otolaryngology | 310 Blue Cavern Point, Long Beach, CA 90803 | 2013-01-09 |
| Find all providers in zip 90803 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114534526 | Lakeysher Swantima Whitfeld | Counselor | 1225 E 3rd St Apt A, Long Beach, CA 90802-3670 | 2020-09-29 |
| 1467061457 | Alex Glowacki | Counselor | 212 Euclid Ave Apt 102, Long Beach, CA 90803-6033 | 2020-07-27 |
| 1154960441 | Asopaepae Ropeti Mulitauaopele | Counselor | 2720 E 56th St, Long Beach, CA 90805-5104 | 2020-01-03 |
| 1689212029 | Brian Scott Becher | Counselor | 4427 E Anaheim St # B, Long Beach, CA 90804-3115 | 2019-12-17 |
| 1134774912 | Asucena Leon | Counselor | 2140 W Wardlow Rd Apt 3, Long Beach, CA 90810-2059 | 2019-08-07 |
| 1649746215 | Cassandra Whitney Dewey | Counselor | 2120 W. Williams Street, Long Beach, CA 90810 | 2018-10-22 |
| 1598240442 | Elle Whitney Anzalone | Counselor | 6502 E Wardlow Rd, Long Beach, CA 90808-4137 | 2018-09-26 |
| 1114404407 | Anthony Sison | Counselor | 1358 Ximeno Ave, Long Beach, CA 90804-3045 | 2018-07-19 |
| 1073026738 | Latrisha S. Stewart | Counselor | 2120 W Williams St Unit 31, Long Beach, CA 90810-3636 | 2017-11-15 |
| 1316462484 | Kathlyn Pearl Parlet | Counselor | 351 E. 6th. Street, Long Beach, CA 90802 | 2017-08-09 |
| Find all providers in LONG BEACH | ||||
| City | LONG BEACH |
| Zip Code | 90803 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.