WILLIE D JACKSON (NPI# 1447349436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447349436 |
| Entity Type | Individual |
| Full Name | WILLIE D JACKSON |
| Practice Address |
11301 Wilshire Blvd Bldg 206 Room 24 Los Angeles CA 90073-1003 |
| Practice Telephone | 3104683711 |
| Practice Fax Number | 3102684765 |
| Mailing Telephone | 3104683711 |
| Mailing Fax Number | 3102684765 |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841571478 | Willie Pearl Jackson | Behavioral Analyst | 5304 Roseland Ave, Las Vegas, NV 89130-2635 | 2011-09-09 |
| 1013143395 | Willie Lee Jackson Jr. | Counselor | 157 Santa Barbara Plz, Los Angeles, CA 90008-2508 | 2009-06-01 |
| 1073754065 | Willie Mae Jackson | Psychiatry & Neurology | 2211 Mayfair Dr, Suite 409, Owensboro, KY 42301-4568 | 2009-03-20 |
| 1477687598 | Willie Jackson | Social Worker | 660 Park St, Jacksonville, FL 32204-2933 | 2007-03-14 |
| 1043312960 | Willie Mae Jackson | Dietetic Technician, Registered | 820 S Damen Ave, Chicago, IL 60612-3728 | 2006-09-01 |
| Street Address |
11301 WILSHIRE BLVD BLDG 206 ROOM 24 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90073-1003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295739043 | Mark S Horng | Internal Medicine | 11301 Wilshire Blvd, 10-c-1, Los Angeles, CA 90073-1003 | 2005-06-09 |
| 1720685944 | Sara Magdalin | Dietitian, Registered | 11301 Wilshire Blvd, Los Angeles, CA 90073-1003 | 2020-10-01 |
| 1336750223 | Nathalie Esther Halajian | Student in an Organized Health Care Education/Training Program | 11301 Wilshire Blvd, Los Angeles, CA 90073-1003 | 2020-08-13 |
| 1811508344 | Hillary Xanthe Enclade | Speech-Language Pathologist | 11301 Wilshire Blvd, Los Angeles, CA 90073-1003 | 2020-08-10 |
| 1356950919 | Maren Abromowitz | Registered Nurse | 11301 Wilshire Blvd, Los Angeles, CA 90073-1003 | 2020-07-29 |
| 1285243030 | Alyson Prince Shittu | Registered Nurse | 11301 Wilshire Blvd, Los Angeles, CA 90073-1003 | 2020-07-28 |
| 1124637087 | Soheil Kooraki | Student in an Organized Health Care Education/Training Program | 11301 Wilshire Blvd, Los Angeles, CA 90073-1003 | 2020-07-27 |
| 1376152371 | Ynez Sabio | Registered Nurse | 11301 Wilshire Blvd, Los Angeles, CA 90073-1003 | 2020-07-24 |
| 1154949972 | Leah Effron | Registered Nurse | 11301 Wilshire Blvd, Los Angeles, CA 90073-1003 | 2020-07-08 |
| 1972120988 | Justin Man Truong | Pharmacist | 11301 Wilshire Blvd, Los Angeles, CA 90073-1003 | 2020-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184223851 | Emily Jenchura | Psychologist | 11301 Wilshire Blvd (116b, Rm. A-130), Los Angeles, CA 90073 | 2020-10-22 |
| 1184285090 | Marcela Leticia Orellana Galvez | Podiatrist | 11301 Wilshire Blvd Bldg 500, Dept of Surgery, #10-h-2, Los Angeles, CA 90073 | 2019-06-23 |
| 1508310996 | Jennifer Maravola | Student in an Organized Health Care Education/Training Program | 11303 Wilshire Bl. Bdg 116, New Direction Inc., Los Angeles, CA 90073 | 2016-08-15 |
| 1861859480 | Michael Fisher | Student in an Organized Health Care Education/Training Program | 11303 Willshire Blv., V.a. Building 116, Los Angeles, CA 90073 | 2016-01-27 |
| 1629453295 | Christopher Denzel Lewis | Student in an Organized Health Care Education/Training Program | 11303 Wilshire Blvd., Va Bldg. 116, Los Angeles, CA 90073 | 2015-07-24 |
| 1689089179 | Rachel Stannus | Social Worker | 11303 Wilshire Blvd, Bldg116, Los Angeles, CA 90073 | 2014-06-24 |
| 1215355433 | Michael Francis Zito | Psychiatry & Neurology | 11301 Wilshire Blvd Bldg 210a, Los Angeles, CA 90073 | 2014-04-03 |
| 1831523901 | Sarah Arensman Miller | Psychologist | 11301 Wilshire Blvd. Bldg 256, Rm 106a, Va West Los Angeles (116b), Los Angeles, CA 90073 | 2013-08-26 |
| 1134447733 | Stuart Thomas Yee | Physical Medicine & Rehabilitation | 11301 Wilshire Blvd. Mail Code 117, Los Angeles, CA 90073 | 2010-05-07 |
| 1306177654 | Pete Petriashvili | Student in an Organized Health Care Education/Training Program | 11301 Wilshire Blvd, Building 500, Room 4455, Los Angeles, CA 90073 | 2010-01-27 |
| Find all providers in zip 90073 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952913055 | Jose Islas | Counselor | 4396 1/2 Lovett St, Los Angeles, CA 90023-4117 | 2020-08-19 |
| 1154931491 | Delia Maria Cortez | Counselor | 12133 Clarkson Rd, Los Angeles, CA 90064-3519 | 2020-08-02 |
| 1457974263 | Simeon Simov | Counselor | 11845 W Olympic Blvd # 815e, Los Angeles, CA 90064-1149 | 2020-05-27 |
| 1780206524 | Keisha Whitfield | Counselor | 1123 W 7th St # 25, Los Angeles, CA 90017-2409 | 2020-05-14 |
| 1467073965 | Flowlab Inc | Counselor | 4528 Los Feliz Blvd, Los Angeles, CA 90027-2006 | 2020-05-06 |
| 1619504925 | Tanisha N Tatum | Counselor | 5777 W Century Blvd # 11102035, Los Angeles, CA 90045-5600 | 2020-03-25 |
| 1083241988 | Rezolve Telemed | Counselor | 8275 Kirkwood Dr, Los Angeles, CA 90046-1923 | 2020-03-23 |
| 1902439656 | Maria Velazquez | Counselor | 5318 S Crenshaw Blvd, Los Angeles, CA 90043-1810 | 2020-02-20 |
| 1922647569 | Ping Sun | Counselor | 520 S Sepulveda Blvd Ste 200, Los Angeles, CA 90049-3534 | 2019-12-30 |
| 1780233213 | Rafael Martin Perez | Counselor | 5955 Hooper Ave Apt A, Los Angeles, CA 90001-1292 | 2019-09-06 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90073 |
Please comment or provide details below to improve the information on WILLIE D JACKSON.
| 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.