JACKSON WATTS (NPI# 1316463433) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316463433 |
| Entity Type | Individual |
| Full Name | JACKSON WATTS |
| Practice Address |
1080 Marina Village Pkwy Ste 100 Alameda CA 94501-1078 |
| Mailing Address |
2390 Portland St Apt 205 Los Angeles CA 90007-1936 |
| Practice Telephone | 5107470513 |
| Enumeration Date | 2017-08-21 |
| Last Update Date | 2017-08-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
1080 MARINA VILLAGE PKWY STE 100 |
| City | ALAMEDA |
| State | CA |
| Zip Code | 94501-1078 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235186313 | Kent C Eller | Psychiatry & Neurology | 1080 Marina Village Pkwy Ste 100, Alameda, CA 94501-1078 | 2006-05-27 |
| 1518587567 | Tyler William Gamlen | Counselor | 1080 Marina Village Pkwy Ste 100, Alameda, CA 94501-1078 | 2020-04-20 |
| 1376038943 | Shane Francis | Registered Nurse | 1080 Marina Village Pkwy Ste 100, Alameda, CA 94501-1078 | 2018-06-26 |
| 1427446319 | Brenda Senseman Holder | Registered Nurse | 1080 Marina Village Pkwy Ste 100, Alameda, CA 94501-1078 | 2014-12-31 |
| 1346652732 | Joseph Landell Roy | Counselor | 1080 Marina Village Pkwy Ste 100, Alameda, CA 94501-1078 | 2014-05-20 |
| 1700208972 | Michelle Bae | Counselor | 1080 Marina Village Pkwy Ste 100, Alameda, CA 94501-1078 | 2014-01-07 |
| 1477811677 | Oshalique Bass | Counselor | 1080 Marina Village Pkwy Ste 100, Alameda, CA 94501-1078 | 2012-04-25 |
| 1487953956 | Thomas Bravo | Counselor | 1080 Marina Village Pkwy Ste 100, Alameda, CA 94501-1078 | 2011-03-22 |
| 1467754846 | Karen Marie Jones | Registered Nurse | 1080 Marina Village Pkwy Ste 100, Alameda, CA 94501-1078 | 2010-11-17 |
| 1245376615 | Edward Leon Kaftarian | Psychiatry & Neurology | 1080 Marina Village Pkwy Ste 100, Alameda, CA 94501-1078 | 2007-01-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386259158 | Hailee Ann Heiselbetz | Behavior Technician | 1025 Atlantic Ave. Ste 101, Alameda, CA 94501 | 2020-09-09 |
| 1134745961 | Linda Nykin | Naturopath | 2002 Monterey Cir, Alameda, CA 94501 | 2020-06-17 |
| 1801427570 | Mirna Rodriguez Lopez | Behavior Technician | 1025 Atlantic Ave. Ste. 101, Alameda, CA 94501 | 2020-01-30 |
| 1356987010 | Guadalupe H Hernandez | Technician | 3650 Mount Diablo Blvd, Layayette, CA 94501 | 2019-11-18 |
| 1952951832 | Lily T Nguyen | Behavior Technician | 1025 Atlantic Ave, Suite 101, Alameda, CA 94501 | 2019-09-12 |
| 1326503004 | Mary Macpherson | Speech-Language Pathologist | 2308 Central Ave., Alameda, CA 94501 | 2019-02-06 |
| 1285103838 | Stephanie Owens | Behavioral Analyst | 2213 Clinton Ave #a, Alameda, CA 94501 | 2018-11-13 |
| 1508349390 | Cindy Cabrera | Behavioral Analyst | 1025 Atlantic Ave Suite 101, Alameda, CA 94501 | 2018-09-08 |
| 1629554928 | Anita Elizabeth Bower | Behavioral Analyst | 125 Atlantic Ave Suite 101, Alameda, CA 94501 | 2018-07-19 |
| 1659862571 | Mariana Rocio Pacas Mexicano | Behavioral Analyst | 1025 Atlantic Ave. Suite 101, Alameda, CA 94501 | 2018-05-26 |
| Find all providers in zip 94501 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316554165 | Darrah Whitman Jones | Student in an Organized Health Care Education/Training Program | 1105 Central Ave, Alameda, CA 94501-2307 | 2020-09-25 |
| 1871121392 | Anna Guo | Student in an Organized Health Care Education/Training Program | 318 Central Ave Apt C, Alameda, CA 94501-3519 | 2020-03-30 |
| 1023641115 | Brendan Michael Ray | Student in an Organized Health Care Education/Training Program | 535 Buena Vista Ave Apt 216, Alameda, CA 94501-2054 | 2020-02-17 |
| 1124681192 | Troy Dufrene | Student in an Organized Health Care Education/Training Program | 2137 San Antonio Ave, Alameda, CA 94501-4326 | 2019-04-16 |
| 1184180259 | Lai Hong Pang | Student in an Organized Health Care Education/Training Program | 611 Taylor Ave, Alameda, CA 94501-3319 | 2019-02-13 |
| 1306353297 | Danielle M Gordon | Student in an Organized Health Care Education/Training Program | 2214 Santa Clara Ave, Alameda, CA 94501-4417 | 2018-01-02 |
| 1073915062 | Namie Lee | Student in an Organized Health Care Education/Training Program | 1080 Marina Village Parkway #100, Alameda, CA 94501 | 2014-09-22 |
| 1073957700 | Kieu T Nguyen | Student in an Organized Health Care Education/Training Program | 2626 Encinal Ave, Alameda, CA 94501-4649 | 2013-04-24 |
| 1710223615 | Julie Susanne Bergen | Student in an Organized Health Care Education/Training Program | 1038 Santa Clara Ave Apt A, Alameda, CA 94501-2330 | 2012-12-20 |
| 1730470840 | Jennifer Munro | Student in an Organized Health Care Education/Training Program | 902 Otis Dr, Alameda, CA 94501-5620 | 2011-04-22 |
| Find all providers in ALAMEDA | ||||
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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.