MRS. GLENDA MARIE JACKSON (NPI# 1053619510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053619510 |
| Entity Type | Individual |
| Full Name | MRS. GLENDA MARIE JACKSON |
| Credential | LVN |
| Practice Address |
5357 Port Sailwood Dr Newark CA 94560-2674 |
| Practice Telephone | 5102822188 |
| Practice Fax Number | 5108942404 |
| Mailing Telephone | 5102822188 |
| Mailing Fax Number | 5108942404 |
| Enumeration Date | 2011-03-08 |
| Last Update Date | 2011-03-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164X00000X | Licensed Vocational Nurse | 203532 | CA | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | TAXONOMY CODE | 164X00000X | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104399823 | Glenda Jackson | Speech-Language Pathologist | 2100 Cedar Dr, Edgewood, MD 21040-2502 | 2019-01-04 |
| 1205291572 | Glenda Elizabeth Jackson | Registered Nurse | 4126 N 16th St, Milwaukee, WI 53209-6915 | 2015-12-30 |
| 1437360716 | Glenda S Jackson | Registered Nurse | 1701 Hardee Ave, Fort Mcpherson, GA 30330 | 2007-05-25 |
| 1134208119 | Glenda L Jackson | Pediatrics | 117 W Liberty Street, Rome, NY 13440 | 2006-11-02 |
| Street Address |
5357 PORT SAILWOOD DR |
| City | NEWARK |
| State | CA |
| Zip Code | 94560-2674 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538713086 | Newark Square Dental Care Inc | Dentist | 5678 Thornton Ave., Newark, CA 94560 | 2019-08-01 |
| 1942788971 | Evelyn Ibanez | Behavioral Analyst | 35201 Lido Blvd, Newark, CA 94560 | 2018-08-01 |
| 1851892954 | Chito Pascual | Nurse Practitioner | 7600 Gateway Blvd., Newark, CA 94560 | 2018-02-23 |
| 1700295466 | Juan Emanuel Tan Santos | Dentist | 5270 Newpark Mall Road, Newark, CA 94560 | 2014-08-07 |
| 1063761146 | Sarah Larae Devoe Scribner | Physical Therapist | 5600 John Muir Road, Newark, CA 94560 | 2012-09-05 |
| 1285983858 | Louie Crespo Ortiz-luis | General Practice | 35455 Dumbarton Court, Newark, CA 94560 | 2012-08-29 |
| 1184932535 | Annie Thanh-yen Du | Psychologist | 3900 Newpark Mall Rd, Ste 300, Newark, CA 94560 | 2010-09-20 |
| 1083931836 | Susan Elizabeth Hanaburgh | Marriage & Family Therapist | 39899 Balentine Drive #212, Family Service of The Tri-cities, Newark, CA 94560 | 2010-05-03 |
| 1306098694 | Maria Isabelle Santos Tuohy | Dentist | 5270 Newpark Plaza, Newark, CA 94560 | 2008-10-17 |
| 1699955765 | Jaspreet Kaur Harika | Dentist | 39736 Cedar Blvd, Newark, CA 94560 | 2007-11-06 |
| Find all providers in zip 94560 | ||||
| Taxonomy Code | 164X00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Vocational Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. [An alternate term for licensed practical nurse arising from difference in occupational titles between states and post-high school training programs and institutions.] Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689212870 | Mandikala Ikota | Licensed Vocational Nurse | 146 Cattlemans Creek Rd, Newark, TX 76071-4327 | 2019-12-18 |
| 1568627743 | Diana L Vega | Licensed Vocational Nurse | 1728 Churchill Downs Rd, Apt A, Newark, OH 43055-3288 | 2008-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255931846 | Deanna Barfield | Licensed Vocational Nurse | 9633 Laurel St, Bellflower, CA 90706-5318 | 2020-10-31 |
| 1710587639 | Steven Wheeler Knight Thomspon | Licensed Vocational Nurse | 10960 Poppy Field Cir, Moreno Valley, CA 92557-3912 | 2020-10-29 |
| 1942800982 | Michelle Marie Toman | Licensed Vocational Nurse | 900 Weber Cir Apt 105, Ventura, CA 93003-8248 | 2020-10-29 |
| 1326647876 | Valeria Brinkers | Licensed Vocational Nurse | 1225 Calle Fantasia, San Marcos, CA 92069-7353 | 2020-10-25 |
| 1417556374 | Rainville Love Dela Salde | Licensed Vocational Nurse | 1300 Adams Ave Apt 12a, Costa Mesa, CA 92626-8315 | 2020-10-21 |
| 1396344222 | Mary Lynn Anderson | Licensed Vocational Nurse | 311 Oceanside Blvd Spc 49, Oceanside, CA 92054-5130 | 2020-10-21 |
| 1689273674 | To Yen Ruby Ngo | Licensed Vocational Nurse | 10501 Valley Blvd Ste 1200, El Monte, CA 91731-3617 | 2020-10-21 |
| 1699374991 | Patricia Ann Perkins | Licensed Vocational Nurse | 3210 Madera Pl, Oxnard, CA 93033-5756 | 2020-10-19 |
| 1003415308 | Veronica Esparza | Licensed Vocational Nurse | 315 E Ventura St Apt 6, Santa Paula, CA 93060-3824 | 2020-10-19 |
| 1649878166 | Crystal Shin | Licensed Vocational Nurse | 3785 Wilshire Blvd Apt 1804, Los Angeles, CA 90010-2893 | 2020-10-16 |
| Find all providers with the same taxonomy | ||||
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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.