MS. JAMIKA JACKSON (NPI# 1003372772) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003372772 |
| Entity Type | Individual |
| Full Name | MS. JAMIKA JACKSON |
| Practice Address |
1517 W Garvey Ave N West Covina CA 91790-2138 |
| Mailing Address |
254 N Spruce Ave Apt 84 Rialto CA 92376-5666 |
| Practice Telephone | 6269626061 |
| Mailing Telephone | 3107143067 |
| Enumeration Date | 2019-02-18 |
| Last Update Date | 2019-02-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 167G00000X | Licensed Psychiatric Technician | 41047 | CA | Nursing Service Providers |
| Street Address |
1517 W GARVEY AVE N |
| City | WEST COVINA |
| State | CA |
| Zip Code | 91790-2138 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679683973 | Pacific Clinics | Community/Behavioral Health | 1517 W Garvey Ave N, West Covina, CA 91790-2138 | 2006-08-30 |
| 1063028405 | Rebecca Ann Beckett | Student in an Organized Health Care Education/Training Program | 1517 W Garvey Ave N, West Covina, CA 91790-2138 | 2020-09-21 |
| 1417563859 | Robin Alyssa Harney | Student in an Organized Health Care Education/Training Program | 1517 W Garvey Ave N, West Covina, CA 91790-2138 | 2020-09-21 |
| 1710530522 | Valerie Arribeno | Counselor | 1517 W Garvey Ave N, West Covina, CA 91790-2138 | 2019-07-20 |
| 1225695398 | Theodore Hardwick | Student in an Organized Health Care Education/Training Program | 1517 W Garvey Ave N, West Covina, CA 91790-2138 | 2019-05-23 |
| 1447713300 | Gershom Israel Chavez | Case Manager/Care Coordinator | 1517 W Garvey Ave N, West Covina, CA 91790-2138 | 2019-04-08 |
| 1013490705 | Peggy Lee Sanchez | Licensed Psychiatric Technician | 1517 W Garvey Ave N, West Covina, CA 91790-2138 | 2018-09-10 |
| 1093208753 | Alma Susana Zarate | Case Manager/Care Coordinator | 1517 W Garvey Ave N, West Covina, CA 91790-2138 | 2018-06-07 |
| 1285132894 | Claud L Flanagan IIi | Case Manager/Care Coordinator | 1517 W Garvey Ave N, West Covina, CA 91790-2138 | 2018-01-29 |
| 1285141887 | Linette Roselle Kanyer | Case Manager/Care Coordinator | 1517 W Garvey Ave N, West Covina, CA 91790-2138 | 2018-01-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285279067 | Liang-wen Chen | Acupuncturist | 1433 West Merced Ave. Suite 304, West Covina, CA 91790 | 2019-11-15 |
| 1245880517 | Cheuk Man Chan | Acupuncturist | 1433 W Merced Ave., #309, West Covina, CA 91790 | 2019-09-18 |
| 1982174561 | Alexandra Isaacs | Marriage & Family Therapist | 1215 W. West Covina Pkwy., West Covina, CA 91790 | 2018-11-27 |
| 1568949709 | Lulua Zulfikarali Bahrainwala | Student in an Organized Health Care Education/Training Program | 1115 S Sunset Avenue #3940, West Covina, CA 91790 | 2018-07-20 |
| 1417442740 | Lydia Joy David | Nurse Practitioner | 1769 S Sunset Ave, West Covina, CA 91790 | 2018-06-28 |
| 1043721046 | Kimberly E Nevarez | Specialist/Technologist | 410 E Merced Ave Suite D, Suite D, West Covina, CA 91790 | 2017-10-17 |
| 1952825754 | Evan Lee Hendriks | Physician Assistant | 301 S Glendora Ave, Apt 2142, West Covina, CA 91790 | 2017-08-02 |
| 1669994588 | Meryl Francine Liu | Dentist | 1101 S. Glendora Ave #a, West Covina, CA 91790 | 2017-07-12 |
| 1326586330 | Athena Merianos | Marriage & Family Therapist | 1215 W. West Parkway, West Covina, CA 91790 | 2017-02-09 |
| 1912445990 | Lissette Bueno | Case Manager/Care Coordinator | 1517 West Garvey Ave North, West Covina, CA 91790 | 2017-02-09 |
| Find all providers in zip 91790 | ||||
| Taxonomy Code | 167G00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Psychiatric Technician |
| An individual licensed by the state board as a Psychiatric Technician based upon completion of a prescribed course of theory and clinical practice, with two thirds of the clinical practice time focused on mental and developmental disorders. The psychiatric technician practices under the direct supervision of a physician, psychologist, registered nurse or other professional to provide care to patients with mental disorders and developmental disabilities. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851737878 | Gilma Stephanie Martinez | Licensed Psychiatric Technician | 1693 Caffrey Ln, West Covina, CA 91791-4142 | 2013-05-16 |
| 1013490705 | Peggy Lee Sanchez | Licensed Psychiatric Technician | 1517 W Garvey Ave N, West Covina, CA 91790-2138 | 2018-09-10 |
| 1881100451 | Micahel Anthony Soto | Licensed Psychiatric Technician | 1517 W Garvey Ave N, West Covina, CA 91790-2138 | 2017-12-19 |
| 1063935567 | Caitlin Leanne Lopez | Licensed Psychiatric Technician | 1825 E Thelborn St, West Covina, CA 91791-1442 | 2017-07-18 |
| 1639574569 | Karina Vizcarra | Licensed Psychiatric Technician | 1517 W Garvey Ave N, West Covina, CA 91790-2138 | 2014-11-04 |
| 1043631930 | Shakira Hunter | Licensed Psychiatric Technician | 1517 W Garvey Ave N, West Covina, CA 91790-2138 | 2013-12-19 |
| 1730521709 | Angela Taylor | Licensed Psychiatric Technician | 1517 W Garvey Ave N, West Covina, CA 91790-2138 | 2013-07-19 |
| 1245543511 | Ricardo Paz | Licensed Psychiatric Technician | 1517 W Garvey Ave N, West Covina, CA 91790-2138 | 2010-07-15 |
| 1326365685 | Elizabeth Castillo | Licensed Psychiatric Technician | 1517 W Garvey Ave N, West Covina, CA 91790-2138 | 2010-04-27 |
| 1306169735 | Andy Garry | Licensed Psychiatric Technician | 1517 W Garvey Ave N, West Covina, CA 91790-2138 | 2010-03-12 |
| Find all providers in WEST COVINA | ||||
| City | WEST COVINA |
| Zip Code | 91790 |
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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.