Brandi Nicole Jackson (NPI# 1255793501, PAC ID# 9335571256) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CLINICAL SOCIAL WORKER.
| Nation Provider ID (NPI) | 1255793501 |
| PAC ID by PECOS | 9335571256 |
| Professional Enrollment ID | I20191114003298 |
| Full Name | Brandi Nicole Jackson |
| Organization Legal Name | HIAWATHA HARRIS MD INC. |
| Address |
2608 Central Ave Suite 1 Union City CA 94587-3148 |
| Phone Number | 5106750600 |
| Gender | F |
| Graduation Year | 2015 |
| Primary Specialty | CLINICAL SOCIAL WORKER |
| Group Practice PAC ID | 1052580115 |
| Number of Group Practice Members | 16 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 1700 Broadway, Suite 500, Oakland, CA 94612-2141 | 5102734200 | HIAWATHA HARRIS MD INC. |
| 2608 Central Ave, Suite 1, Union City, CA 94587-3148 | 5106750600 | HIAWATHA HARRIS MD INC. |
| Organization Legal Name | HIAWATHA HARRIS MD INC. |
| Physicians | 19 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Elizabeth Mole | Nurse Practitioner | Hiawatha Harris Md Inc. | 5674 Stoneridge Dr, Suite 205, Pleasanton, CA 94588-8585 |
| Marina Obolnikov | Psychiatry | Hiawatha Harris Md Inc. | 1700 Broadway, Suite 500, Oakland, CA 94612-2141 |
| Gordon Juan | Psychiatry | Hiawatha Harris Md Inc. | 2608 Central Ave, Suite 1, Union City, CA 94587-3148 |
| Lester E Love | Psychiatry | Hiawatha Harris Md Inc. | 1700 Broadway, Suite 500, Oakland, CA 94612-2141 |
| Joan Alviar Fraino | Nurse Practitioner | Hiawatha Harris Md Inc. | 5674 Stoneridge Dr, Suite 205, Pleasanton, CA 94588-8585 |
| Carolyn D Harris-muchell | Nurse Practitioner | Hiawatha Harris Md Inc. | 1700 Broadway, Suite 500, Oakland, CA 94612-2141 |
| Gilda R Versales | Psychiatry | Hiawatha Harris Md Inc. | 2608 Central Ave, Suite 1, Union City, CA 94587-3148 |
| Danicka Xuan Le | Nurse Practitioner | Hiawatha Harris Md Inc. | 2608 Central Ave, Suite 1, Union City, CA 94587-3148 |
| Yasin Mansoor | Psychiatry | Hiawatha Harris Md Inc. | 2608 Central Ave, Suite 1, Union City, CA 94587-3148 |
| Gwendolyn Rothman | Psychiatry | Hiawatha Harris Md Inc. | 1700 Broadway, Suite 500, Oakland, CA 94612-2141 |
| Street Address |
2608 CENTRAL AVE SUITE 1 |
| City | UNION CITY |
| State | CA |
| Zip | 94587-3148 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gordon Juan | Psychiatry | Hiawatha Harris Md Inc. | 2608 Central Ave, Suite 1, Union City, CA 94587-3148 |
| Gilda R Versales | Psychiatry | Hiawatha Harris Md Inc. | 2608 Central Ave, Suite 1, Union City, CA 94587-3148 |
| Danicka Xuan Le | Nurse Practitioner | Hiawatha Harris Md Inc. | 2608 Central Ave, Suite 1, Union City, CA 94587-3148 |
| Yasin Mansoor | Psychiatry | Hiawatha Harris Md Inc. | 2608 Central Ave, Suite 1, Union City, CA 94587-3148 |
| Lisa Torre-igwe | Nurse Practitioner | Hiawatha Harris Md Inc. | 2608 Central Ave, Suite 1, Union City, CA 94587-3148 |
| Amber Aguilar | Nurse Practitioner | Hiawatha Harris Md Inc. | 2608 Central Ave, Suite 1, Union City, CA 94587-3148 |
| Armando Medina Braganza | Psychiatry | Hiawatha Harris Md Inc. | 2608 Central Ave, Suite 1, Union City, CA 94587-3148 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Priyanka A Chheda | Physical Therapy | Samasta Services Inc | 2805 Whipple Rd, Union City, CA 94587-1233 |
| Army Patel | Physical Therapy | Samasta Services Inc | 2805 Whipple Rd, Union City, CA 94587-1233 |
| Nimoli Malhotra | Physical Therapy | Samasta Services Inc | 2805 Whipple Rd, Union City, CA 94587-1233 |
| Ketki P Marathe | Physical Therapy | Samasta Services Inc | 2805 Whipple Rd, Union City, CA 94587-1233 |
| Leila Marinel S Le Godais | Physical Therapy | Samasta Services Inc | 2805 Whipple Rd, Union City, CA 94587-1233 |
| Christina M Cu-unjieng | Physical Therapy | Permanente Medical Group Inc | 3555 Whipple Rd, Union City, CA 94587-1507 |
| Catherine M Knox | Ophthalmology | Permanente Medical Group Inc | 3553 Whipple Rd, Union City, CA 94587-1507 |
| Anjana Vinayak Harnoor | Internal Medicine | Permanente Medical Group Inc | 3553 Whipple Rd, Union City, CA 94587-1507 |
| Anthony C Toy | Optometry | Permanente Medical Group Inc | 3553 Whipple Rd, Union City, CA 94587-1507 |
| Sarah Sheu | Dermatology | Permanente Medical Group Inc | 3555 Whipple Rd, Union City, CA 94587-1507 |
| Find all physicians in zip 94587 | |||
| City | UNION CITY |
| Zip Code | 94587 |
| Specialty | CLINICAL SOCIAL WORKER |
| City + Specialty | UNION CITY + CLINICAL SOCIAL WORKER |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.