MR. ROBERT ROMULUS JACKSON I (NPI# 1164058657) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164058657 |
| Entity Type | Individual |
| Full Name | MR. ROBERT ROMULUS JACKSON I |
| Practice Address |
11600 Eldridge Ave Sylmar CA 91342-6506 |
| Practice Telephone | 6612089964 |
| Mailing Telephone | 6612089964 |
| Enumeration Date | 2020-03-17 |
| Last Update Date | 2020-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | CA | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538701487 | Robert Jackson | Physical Therapist | 3056 Healthy Way Ste 116, Birmingham, AL 35243-2435 | 2019-10-11 |
| 1881003655 | Robert Donald Jackson | Social Worker | 151 Knollcroft Rd # 116d, Lyons, NJ 07939-5001 | 2014-08-06 |
| 1780005496 | Robert Earl Jackson Jr. | Community Health Worker | 17 Wickham Dr, Columbus, GA 31907-6328 | 2013-12-23 |
| 1073942371 | Robert Jackson | Massage Therapist | 502 11th St Se, Decatur, AL 35601-4908 | 2013-11-06 |
| 1447548573 | Robert Joseph Jackson | Licensed Practical Nurse | 5454 East State St, Hermitage, PA 16148 | 2011-07-11 |
| 1457515330 | Robert Anthony Jackson | Dentist | 2816 Veach Rd., Unit 305, Owensboro, KY 42303 | 2008-07-10 |
| 1437357399 | Robert D Jackson | Counselor | 5525 Erindale Dr Ste 112, Colorado Springs, CO 80918-6960 | 2007-07-03 |
| 1174736029 | Robert Allan Jackson | Physician Assistant | 2109 Brookview Ter Apt B, Pekin, IL 61554-7320 | 2007-05-08 |
| 1144389347 | Robert W Jackson | Dentist | 209 Mimosa Dr, Thomasville, GA 31792-6633 | 2006-12-06 |
| 1144305152 | Robert Eric Jackson | Internal Medicine | 291 Indian Lake Blvd, Hendersonville, TN 37075-3653 | 2006-10-26 |
| Street Address |
11600 ELDRIDGE AVE |
| City | SYLMAR |
| State | CA |
| Zip Code | 91342-6506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982203956 | Pedro Eduardo Rivas | Rehabilitation Practitioner | 11600 Eldridge Ave, Sylmar, CA 91342-6506 | 2020-10-21 |
| 1063068203 | Elizabeth Fredgant | Student in an Organized Health Care Education/Training Program | 11600 Eldridge Ave, Sylmar, CA 91342-6506 | 2019-08-13 |
| 1063064434 | Israel Emmanuel El'shaddai | Counselor | 11600 Eldridge Ave, Sylmar, CA 91342-6506 | 2019-07-15 |
| 1922567460 | Andreas Eugene Branch | Counselor | 11600 Eldridge Ave, Sylmar, CA 91342-6506 | 2019-03-14 |
| 1649747585 | Mary Salveron | Licensed Vocational Nurse | 11600 Eldridge Ave, Sylmar, CA 91342-6506 | 2018-10-29 |
| 1184104671 | Lilly Marie Temple | Student in an Organized Health Care Education/Training Program | 11600 Eldridge Ave, Sylmar, CA 91342 | 2018-08-15 |
| 1538608732 | Ana Gonzalez | Licensed Vocational Nurse | 11600 Eldridge Ave, Sylmar, CA 91342-6506 | 2017-02-21 |
| 1205260635 | Ryan James Sullivan | Marriage & Family Therapist | 11600 Eldridge Ave, Sylmar, CA 91342-6506 | 2013-08-21 |
| 1215260518 | Ninoska Molina Weckl | Marriage & Family Therapist | 11600 Eldridge Ave, Sylmar, CA 91342-6506 | 2009-09-17 |
| 1467686998 | Maxine Marie Hughes | Marriage & Family Therapist | 11600 Eldridge Ave, Sylmar, CA 91342-6506 | 2009-05-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629687223 | Evelyn Pinto Morales | Technician, Other | 14445 Olive View Dr, Sylmar, CA 91342 | 2020-07-29 |
| 1528520988 | Yeun Lim | Student in an Organized Health Care Education/Training Program | 14445 Olive View Dr., Cottage H1, Attn D. Ray, Sylmar, CA 91342 | 2019-04-04 |
| 1467914317 | Sevak Hovagimyan | Pharmacist | 13677 Foothill Blvd #b, Sylmar, CA 91342 | 2019-04-01 |
| 1619455086 | Cameda Trichele Dickerson | Counselor | Phoenix House 116600 Eldridge, Lake View Terrace, CA 91342 | 2018-07-30 |
| 1407349624 | Joseph Sungkon Choi | Acupuncturist | 10274 Foothill Blvd, Sylmar, CA 91342 | 2018-06-12 |
| 1780194522 | Joe Anthony Cardenas | Specialist/Technologist | 15450 Roxford Street, Sylmar, CA 91342 | 2017-10-06 |
| 1336668466 | Juan Hernandez | Chiropractor | 13950 Foothill Blvd Apt 108, Sylmar, CA 91342 | 2017-09-09 |
| 1891213492 | Richard Ignacio Martinez | Nurse Practitioner | 14987 Oro Grande St., Sylmar, CA 91342 | 2017-09-03 |
| 1104349497 | Vanessa Gamboa | Social Worker | 13145 Bromont Ave., 14, Sylmar, CA 91342 | 2017-07-19 |
| 1982138368 | Christina Guest | Psychiatry & Neurology | Olive View Medical Center, 14445 Olive View Drive, Sylmar, CA 91342 | 2017-04-12 |
| Find all providers in zip 91342 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154893634 | Socorro Huerta | Case Manager/Care Coordinator | 16601 Foothill Blvd Apt 303, Sylmar, CA 91342-1167 | 2018-12-21 |
| 1861847428 | Robert Vasquez | Case Manager/Care Coordinator | 13046 Aztec St, Sylmar, CA 91342-2501 | 2016-05-02 |
| 1538794318 | Alina Danielyan-makoyan | Case Manager/Care Coordinator | 14445 Olive View Dr, Sylmar, CA 91342-1437 | 2020-03-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275935 | Grecia Leticia Garcia | Case Manager/Care Coordinator | 1830 Rodgers Rd Apt F, Hanford, CA 93230-1930 | 2020-11-03 |
| 1679173835 | Cristina Palacios-gomez | Case Manager/Care Coordinator | 1834 E Lester Ave, Fresno, CA 93720-1963 | 2020-10-27 |
| 1417557653 | Jeannine Arnetta Nash | Case Manager/Care Coordinator | 7614 Lemon Ave Ste C, Lemon Grove, CA 91945-1619 | 2020-10-27 |
| 1932709359 | Vue Moua | Case Manager/Care Coordinator | 4812 Conzelman Way, Elk Grove, CA 95757-2508 | 2020-10-26 |
| 1932709458 | Andre Howard | Case Manager/Care Coordinator | 2281 Hurley Way Apt 10, Sacramento, CA 95825-2337 | 2020-10-26 |
| 1194324020 | Project Raised | Case Manager/Care Coordinator | 3839 Amanda St, Unit 133, West Covina, CA 91792-2759 | 2020-10-21 |
| 1528667854 | Sarah Claudio | Case Manager/Care Coordinator | 650 Howe Ave # 400-b, Sacramento, CA 95825 | 2020-10-19 |
| 1750989240 | David John Schmidt-cook | Case Manager/Care Coordinator | 5580 Foothill Rd, Rocklin, CA 95677-3316 | 2020-10-15 |
| 1164020459 | Karina Montes Rodriguez | Case Manager/Care Coordinator | Cip 1540 Florida Ave, Suite 212, Modesto, CA 95350 | 2020-10-09 |
| 1841897675 | Madeline Hannah Starkenburg | Case Manager/Care Coordinator | 11559 Claridge Dr, Rch Cucamonga, CA 91730-7246 | 2020-10-05 |
| Find all providers with the same taxonomy | ||||
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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.