NANCY J. JACKSON (NPI# 1497002406) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497002406 |
| Entity Type | Individual |
| Full Name | NANCY J. JACKSON |
| Practice Address |
1738 N Waterman Ave San Bernardino CA 92404-5131 |
| Mailing Address |
Po Box 3868 Hemet CA 92546-3868 |
| Practice Telephone | 9516634848 |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2018-11-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386113330 | Nancy N Jackson | Licensed Vocational Nurse | 6213 Reddenson Dr, Fort Worth, TX 76132-5049 | 2018-11-20 |
| 1497157077 | Nancy Ann Jackson | Massage Therapist | 1010 Danconia Dr, Trail, OR 97541-9702 | 2014-09-25 |
| 1568690071 | Nancy M Jackson | Chore Provider | 4019 Overland Pkwy, Toledo, OH 43612-1616 | 2009-06-24 |
| 1720206162 | Nancy Louise Jackson | Registered Nurse | 9408 Van Antwerp Rd, Brighton, MI 48116-6245 | 2007-04-23 |
| 1548334634 | Nancy Jo Jackson | Counselor | 4127 Francisco St, Pleasanton, CA 94566-5616 | 2006-11-20 |
| 1487615191 | Nancy Jackson | Nurse Practitioner | 1115 Garredd Blvd, Augusta, GA 30909 | 2006-03-31 |
| 1730708975 | Nancy Angelia Jackson | Speech-Language Pathologist | 2655 Villa Creek Dr Ste 140, Dallas, TX 75234-7385 | 2020-04-08 |
| 1801216759 | Nancy Jackson | Student in an Organized Health Care Education/Training Program | 530 Nw 27th St, Corvallis, OR 97330-5223 | 2014-04-18 |
| 1821419433 | Nancy Jackson | Behavioral Analyst | 701 Jefferson Ave, Suite 301, Toledo, OH 43604-6955 | 2013-12-27 |
| 1225380959 | Nancy Jackson | Licensed Practical Nurse | 4 Jefferson Plz, Poughkeepsie, NY 12601-4035 | 2012-10-04 |
| Street Address |
1738 N WATERMAN AVE |
| City | SAN BERNARDINO |
| State | CA |
| Zip Code | 92404-5131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194164913 | Inlandpsych Redlands Inc. | Psychiatry & Neurology | 1738 N Waterman Ave, 2, San Bernardino, CA 92404-5131 | 2013-06-14 |
| 1962577080 | Ernest Clayton Levister Jr. | Internal Medicine | 1738 N Waterman Ave, Suite 1, San Bernardino, CA 92404-5135 | 2006-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740849363 | Danniella Alexandra Murillo | Physician Assistant | 2101 North Waterman Ave, San Bernardino, CA 92404 | 2019-06-07 |
| 1902377484 | Shauntel Renee Nelson | Student in an Organized Health Care Education/Training Program | 1481 N. Windsor Dr., San Bernardino, CA 92404 | 2018-12-10 |
| 1487123584 | Garrett M Grigg | Licensed Psychiatric Technician | 1481 N Windsor Dr, San Bernardino, CA 92404 | 2018-11-19 |
| 1881163434 | James Dean Anders | Counselor | 1481 Windsor Drive, San Bernardino, CA 92404 | 2018-11-13 |
| 1043703564 | Samantha Makpaiboonvatana | Optometrist | 1909 N Waterman Ave Ste 3, San Bernardino, CA 92404 | 2018-06-09 |
| 1861981623 | Christopher Windham | Behavior Technician | 2460 Fremontia Dr, San Bernardino, CA 92404 | 2018-05-08 |
| 1891145041 | Cynthia Lusy Gastelum | Marriage & Family Therapist | 1885 E Lynwood Dr Rm Se3, San Bernardino, CA 92404 | 2016-06-20 |
| 1336598259 | Foundation Enterprises LLC | Non-emergency Medical Transport (VAN) | 1663 Date Pl., #30390, San Bernardino, CA 92404 | 2016-06-10 |
| 1881042877 | Helen Ann Thompson | Speech-Language Pathologist | 1311 E. State St., San Bernardo, CA 92404 | 2016-05-31 |
| 1366839938 | Lanecia Richardson | Counselor | 135 Paul Drive, San Rafeal, CA 92404 | 2015-04-22 |
| Find all providers in zip 92404 | ||||
| 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 |
|---|---|---|---|---|
| 1154935492 | Julian Ellison | Case Manager/Care Coordinator | 303 E Vandebilt Way, San Bernardino, CA 92415-0001 | 2020-09-03 |
| 1639789233 | Luis Enrique Macias | Case Manager/Care Coordinator | 26967 Beaumont Ave., Redlands Ca 92373, San Bernardino, CA 92407 | 2020-08-07 |
| 1619537016 | Shaunice Renee Cox | Case Manager/Care Coordinator | 1604 Pennsylvania Street, San Bernardino, CA 92411 | 2019-06-18 |
| 1528523065 | Leslie Gonzalez | Case Manager/Care Coordinator | 1982 W 18th St, San Bernardino, CA 92411-1059 | 2019-02-08 |
| 1326520057 | Cynthia Gutierrez | Case Manager/Care Coordinator | 237 E. Mill St., San Bernardino, CA 92408 | 2018-08-29 |
| 1457831398 | Omar Torres | Case Manager/Care Coordinator | 574 N Arrowhead Ave., San Bernardino, CA 92401 | 2018-08-20 |
| 1558841197 | Yvette Hinton | Case Manager/Care Coordinator | 431 Mackay Drive, San Bernardino, CA 92408 | 2018-08-14 |
| 1326557026 | Ruben Grajeda | Case Manager/Care Coordinator | 3561 N F St, San Bernardino, CA 92405-2120 | 2017-09-25 |
| 1225553472 | Nicole Dela Cruz | Case Manager/Care Coordinator | 720 E Gilbert Street, San Bernardino, CA 92415-0001 | 2017-08-09 |
| 1104354539 | Llesenia Aleman | Case Manager/Care Coordinator | 597 North Arrowhead Ave, San Bernardino, CA 92401 | 2017-05-30 |
| Find all providers in SAN BERNARDINO | ||||
| City | SAN BERNARDINO |
| Zip Code | 92404 |
Please comment or provide details below to improve the information on NANCY J. 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.