Jacob Jawn Allen, SUD COUNSELOR
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Hawthorne, CA
NPI 1982418331 · NPPES record last updated May 28, 2025
Key facts
- NPI
- 1982418331
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 13385 (CA)
- Practice address
- 2501 W El Segundo Blvd
Hawthorne, CA 90250-3317 - Phone
- (562) 805-4363
- NPI assigned
- Feb 5, 2025
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13385 | CA | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | 13385 | CA | Yes |
Addresses
Primary practice location
2501 W El Segundo Blvd
Hawthorne, CA 90250-3317
Mailing address
3613 W 146TH St
Hawthorne, CA 90250-8454
Phone (323) 497-0766
Other providers in Hawthorne, CA
- Nima Alipour
- Allcare Personal Care Services Inc
- Amy A Allen
- Douglas James Allen
- Gloria Ann Allen
- Kiara Althaus
- Ingrid Alvarez
- Mariah Alvarez
- Ruby Alvarez
- Always Stay Home Nursing Service Inc.
All providers in Hawthorne, CA · Addiction (Substance Use Disorder) Counselor in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 28, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.