JACKAE MAYFIELD (NPI# 1861965295) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861965295 |
| Entity Type | Individual |
| Full Name | JACKAE MAYFIELD |
| Practice Address |
11303 Wilshire Blvd Bldg 116 Los Angeles CA 90025-5069 |
| Practice Telephone | 3109144045 |
| Mailing Telephone | 3109144045 |
| Enumeration Date | 2019-01-08 |
| Last Update Date | 2019-01-08 |
| 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 |
| Street Address |
11303 WILSHIRE BLVD BLDG 116 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90025-5069 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104044270 | Cheryl Hackett | Case Manager/Care Coordinator | 11303 Wilshire Blvd Bldg 116, Los Angeles, CA 90025-5069 | 2007-04-23 |
| 1356956585 | Tiffany Nicole Derosier | Rehabilitation Practitioner | 11303 Wilshire Blvd Bldg 116, Los Angeles, CA 90025-5069 | 2020-09-14 |
| 1225649544 | Donnie Albert Agnew | Rehabilitation Practitioner | 11303 Wilshire Blvd Bldg 116, Los Angeles, CA 90025-5069 | 2020-08-11 |
| 1063037729 | Larmar Ervin Avila | Rehabilitation Practitioner | 11303 Wilshire Blvd Bldg 116, Los Angeles, CA 90025-5069 | 2020-06-09 |
| 1023645322 | Josh Alfred Cleary | Marriage & Family Therapist | 11303 Wilshire Blvd Bldg 116, Los Angeles, CA 90025-5069 | 2020-03-25 |
| 1649810565 | Alexandria Holcomb | Student in an Organized Health Care Education/Training Program | 11303 Wilshire Blvd Bldg 116, Los Angeles, CA 90025-5069 | 2020-01-08 |
| 1285289140 | Richard Carnell Donaldson | Rehabilitation Practitioner | 11303 Wilshire Blvd Bldg 116, Los Angeles, CA 90025-5069 | 2019-08-07 |
| 1841843513 | Darryl Lovett | Rehabilitation Practitioner | 11303 Wilshire Blvd Bldg 116, Los Angeles, CA 90025-5069 | 2019-07-22 |
| 1659933521 | Bobby Gene Glover Jr I | Community Health Worker | 11303 Wilshire Blvd Bldg 116, Los Angeles, CA 90025-5069 | 2019-07-01 |
| 1679036982 | Tyler James Craft | Case Manager/Care Coordinator | 11303 Wilshire Blvd Bldg 116, Los Angeles, CA 90025-5069 | 2019-04-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558962324 | Marjan-marcia Khalitchi-alavi | Psychologist | 12400 Wilshire Blvd #230, Los Angeles, CA 90025 | 2020-11-06 |
| 1245852599 | Maureen Bridget Mcglynn | Marriage & Family Therapist | 1531 Purdue Avenue, Los Angeles, CA 90025 | 2020-05-09 |
| 1578118857 | Gregory J Bogie | Physical Therapist | 10351 Santa Monica Blvd. Suite 101, Los Angeles, CA 90025 | 2019-08-05 |
| 1518527712 | David Allen Goldstein | Marriage & Family Therapist | 12301 Wilshire Blvd., Suite 515, Los Angeles, CA 90025 | 2019-06-19 |
| 1386104875 | Kevin Meir Youssefzadeh | Student in an Organized Health Care Education/Training Program | 304 Dowlen Dr, Los Angeles, CA 90025 | 2019-03-21 |
| 1336609189 | Psychotherapy Center for Healing and Personal Growth | Psychologist | 2001 S. Barington Ave Suite 222, Los Angeles, CA 90025 | 2019-03-20 |
| 1477028819 | Flora Ma | Nurse Practitioner | 1726 Purdue Ave, Apt 2, Los Angeles, CA 90025 | 2018-10-12 |
| 1457834285 | Yeesul Yoo | Chiropractor | 2001 S. Barrington Ave Suite 101, Los Angeles, CA 90025 | 2018-09-07 |
| 1902387160 | Angelica Carmen Regalado | Behavior Technician | 7400 Pacific Blvd. Suite A & B, Walnut Park, CA 90025 | 2018-08-26 |
| 1033603378 | Craig Allen Gillett | Marriage & Family Therapist | 11847 Wilshire Blvd., #300, Los Angeles, CA 90025 | 2018-06-20 |
| Find all providers in zip 90025 | ||||
| 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 |
|---|---|---|---|---|
| 1285242594 | Rocio Jimenez | Case Manager/Care Coordinator | 4650 Sunset Blvd, Mailstop #53, Los Angeles, CA 90027 | 2020-07-22 |
| 1245855725 | Ashley Ivette Berumen | Case Manager/Care Coordinator | 1900 W Slauson Ave, Los Angeles, CA 90047-1129 | 2020-06-10 |
| 1356965776 | Jennifer Yanovski | Case Manager/Care Coordinator | 316 W 2nd St Ste 202, Los Angeles, CA 90012-3527 | 2020-06-01 |
| 1841820560 | Kiara Imani Thomas | Case Manager/Care Coordinator | 226 E 103rd St, Los Angeles, CA 90003-4720 | 2020-01-22 |
| 1023648748 | Christopher Rivas | Case Manager/Care Coordinator | 1410 N Kenmore Ave Apt 5, Los Angeles, CA 90027-5826 | 2020-01-22 |
| 1396383782 | Candace Laolagi | Case Manager/Care Coordinator | 246 E 47th St, Los Angeles, CA 90011-3908 | 2019-12-16 |
| 1902448343 | Aster Libasu | Case Manager/Care Coordinator | 2619 Wilshire Blvd Apt 1005, Los Angeles, CA 90057-3461 | 2019-10-16 |
| 1831749456 | Jasmine Lynn Martinez | Case Manager/Care Coordinator | 6768 Lexington Ave, Los Angeles, CA 90038-1234 | 2019-09-16 |
| 1033762547 | John Charles Gutierrez | Case Manager/Care Coordinator | 4265 S Normandie Ave, Los Angeles, CA 90037-2324 | 2019-07-23 |
| 1609429976 | Vianey Colon | Case Manager/Care Coordinator | 11601 S Western Ave # O, Los Angeles, CA 90047-5006 | 2019-07-16 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90025 |
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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.