MRS. SHIRLEY JACKSON (NPI# 1396926499) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396926499 |
| Entity Type | Individual |
| Full Name | MRS. SHIRLEY JACKSON |
| Credential | SOCIAL SERVICE WORK |
| Practice Address |
3625 14th St Riverside CA 92501-3815 |
| Mailing Address |
Po Box 1405 Riverside CA 92502-1405 |
| Practice Telephone | 9519551582 |
| Practice Fax Number | 9519551610 |
| Mailing Telephone | 9513416440 |
| Enumeration Date | 2007-11-16 |
| Last Update Date | 2020-08-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073915559 | Shirley Jackson | Occupational Therapy Assistant | 170 Village Court, Martinsville, VA 24112 | 2014-09-16 |
| 1538218292 | Shirley Jean Jackson | Registered Nurse | 21 North Atwood Ave, Janesville, WI 53648 | 2007-01-10 |
| 1790343507 | Shirley Jackson | Counselor | 245 11th St, San Francisco, CA 94103-3732 | 2019-06-05 |
| 1558806687 | Shirley Jackson | Substance Abuse Rehabilitation Facility | 2151 Rush Blvd, Youngstown, OH 44507-1535 | 2016-12-28 |
| 1144689936 | Shirley Jackson | Licensed Vocational Nurse | 9808 Venice Blvd, Ste. 505, Culver City, CA 90232-2732 | 2016-02-22 |
| 1982943486 | Shirley Jackson | Registered Nurse | 7600 Geogia Ave, Suite 323, Washington, DC 20012 | 2013-02-05 |
| 1407947484 | Shirley A Jackson | Counselor | 1400 Vfw Pkwy, West Roxbury, MA 02132-4927 | 2006-09-27 |
| Street Address |
3625 14TH ST |
| City | RIVERSIDE |
| State | CA |
| Zip Code | 92501-3815 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326124751 | Praise C Okoh | Marriage & Family Therapist | 3625 14th St, Riverside, CA 92501-3815 | 2006-10-27 |
| 1558968396 | Jessierae Contreras | Counselor | 3625 14th St, Riverside, CA 92501-3815 | 2020-10-05 |
| 1639784218 | Pamela Joyce Mckee | Counselor | 3625 14th St, Riverside, CA 92501-3815 | 2020-09-10 |
| 1346865946 | Melissa Coulson | Social Worker | 3625 14th St, Riverside, CA 92501-3815 | 2020-06-10 |
| 1245863091 | Horace William Corey Jr. | Counselor | 3625 14th St, Riverside, CA 92501-3815 | 2020-02-20 |
| 1356974869 | Carissa T Glover | Counselor | 3625 14th St, Riverside, CA 92501-3815 | 2020-02-13 |
| 1790324366 | Garland Edward Brotherton | Counselor | 3625 14th St, Riverside, CA 92501-3815 | 2019-12-31 |
| 1750927125 | Kimberlee Sue Maternowski | Licensed Vocational Nurse | 3625 14th St, Riverside, CA 92501-3815 | 2019-11-20 |
| 1982246518 | Robyn Michel Loyd | Counselor | 3625 14th St, Riverside, CA 92501-3815 | 2019-10-15 |
| 1083175921 | Dena Racquel Washington | Licensed Vocational Nurse | 3625 14th St, Riverside, CA 92501-3815 | 2019-03-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700437605 | Mary Horvatin | Technician | 1811 Rivera Strret, Riverside, CA 92501 | 2019-09-23 |
| 1366905473 | Timothy Daniel Collins | Student in an Organized Health Care Education/Training Program | Riverside Community Hospital, 4445 Magnolia Ave., Gme, Office, Riverside, CA 92501 | 2019-04-08 |
| 1346709672 | Lourdes Adame | Student in an Organized Health Care Education/Training Program | 4445 Magnolia Ave - Gme Office, Riverside, CA 92501 | 2019-03-16 |
| 1740759067 | Kristina Ferris-celosse | Counselor | 2452 Wilshire St., Riverside, CA 92501 | 2018-11-15 |
| 1750888095 | Arunmozhi Aravagiri | Student in an Organized Health Care Education/Training Program | Riverside Community Hospital, Gme Office, 4445 Magnolia Ave., Riverside, CA 92501 | 2018-04-12 |
| 1720585847 | Alan Huynh | Student in an Organized Health Care Education/Training Program | 4445 Magnolia Avenue., Gme Office, Riverside, CA 92501 | 2018-04-06 |
| 1538664834 | Wilson Paul Frasca | Student in an Organized Health Care Education/Training Program | 4445 Magnolia Avenue, Riverside, CA 92501 | 2018-03-28 |
| 1851896575 | Geethu Gopinathan Nair | Student in an Organized Health Care Education/Training Program | Riverside Community Hospital, 4445 Magnolia Ave., Gme Office, Riverside, CA 92501 | 2018-03-26 |
| 1316465560 | Thilini Anne Abeygunaratne | Marriage & Family Therapist | 1950 Market Street, Riverside, CA 92501 | 2017-09-07 |
| 1194257410 | Melissa Chitwood | Assistant Behavior Analyst | 3078 Cedar St., Riverside, CA 92501 | 2017-03-28 |
| Find all providers in zip 92501 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205448917 | Rachel Nielson | Counselor | 1450 Spruce St, Suite A, Riverside, CA 92507 | 2020-08-24 |
| 1023638541 | Sarah Davidson-amici | Counselor | 2167 Buckskin Pl, Riverside, CA 92506-4608 | 2020-04-24 |
| 1790311470 | Melanie S David | Counselor | 11498 Pierce St Ste A&b, Riverside, CA 92505-3357 | 2020-03-13 |
| 1548890155 | Taylor Jean Robitzer I | Counselor | 16435 Trisha Way, Riverside, CA 92504-5731 | 2020-01-23 |
| 1043854714 | Marie Apke | Counselor | 493 Uvedale Rd, Riverside, IL 60546-1608 | 2019-11-05 |
| 1851934954 | Community Access Network | Counselor | 16542 Tava Ln, Riverside, CA 92504-5833 | 2019-10-21 |
| 1124661236 | Community Access Network | Counselor | 10631 Orchard View Ln, Riverside, CA 92503-6605 | 2019-10-21 |
| 1518519503 | Erica Elissa Sierra | Counselor | 2085 Rustin Ave Ofc 2157, Riverside, CA 92507-2498 | 2019-07-10 |
| 1508344714 | Patricia Marraine Redondo | Counselor | 1625 14th St, Riverside, CA 92503 | 2018-07-31 |
| 1518445725 | Ryan Gregory Galippo | Counselor | 1625 14th Street, Riverside, CA 92513-7549 | 2018-07-31 |
| Find all providers in RIVERSIDE | ||||
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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.