MS. COLLEEN DELORES JACKSON (NPI# 1134331259) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134331259 |
| Entity Type | Individual |
| Full Name | MS. COLLEEN DELORES JACKSON |
| Credential | NURSE PRACTITIONER |
| Practice Address |
8700 Beverly Blvd Thalians 2w, Rm 218 West Hollywood CA 90048-1804 |
| Mailing Address |
849 Manzanita Ave Pasadena CA 91103-2961 |
| Practice Telephone | 3104238572 |
| Practice Fax Number | 3104238550 |
| Mailing Telephone | 3104238572 |
| Mailing Fax Number | 3104238550 |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
12835 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447762844 | Colleen Jackson | Occupational Therapy Assistant | 8011 Elkhart Ave, Lubbock, TX 79424-2615 | 2017-10-26 |
| 1699317263 | Colleen M Jackson | Counselor | 1136 S Delano Ct W Ste B201, Chicago, IL 60605-3734 | 2019-10-15 |
| 1952765661 | Colleen E Jackson | Clinical Neuropsychologist | 150 S Huntington Ave, Boston Va Medical Center (116b), Boston, MA 02130-4817 | 2016-04-08 |
| 1801269840 | Colleen Q Jackson | Licensed Practical Nurse | 224 Harrison St, Suite 680, Syracuse, NY 13202-3056 | 2015-11-12 |
| 1669629275 | Colleen A Jackson | Nutritionist | 101 Hospital Rd, Patchogue, NY 11772-4870 | 2008-08-26 |
| 1346354073 | Colleen Marie Jackson | Durable Medical Equipment & Medical Supplies | 417 E Baltimore St, Unit A, Taneytown, MD 21787-2300 | 2006-08-19 |
| Street Address |
8700 BEVERLY BLVD THALIANS 2W, RM 218 |
| City | WEST HOLLYWOOD |
| State | CA |
| Zip Code | 90048-1804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013910983 | Denise A Barbuto | Specialist | 8700 Beverly Blvd, Rm 8725, West Hollywood, CA 90048-1804 | 2005-05-24 |
| 1609481688 | Shawn Younessi Md Inc | Internal Medicine | 8700 Beverly Blvd, West Hollywood, CA 90048-1804 | 2020-09-15 |
| 1447865860 | Elyssa Bangunan Rivero | Nurse Practitioner | 8700 Beverly Blvd, West Hollywood, CA 90048-1804 | 2020-09-11 |
| 1508471301 | Matthew Ryan Beckelman | Nurse Practitioner | 8700 Beverly Blvd, West Hollywood, CA 90048-1804 | 2020-09-09 |
| 1255941514 | Josias Cerritos Escobar | Nurse Practitioner | 8700 Beverly Blvd, West Hollywood, CA 90048-1804 | 2020-08-03 |
| 1841818945 | Jocelyn Chaing | Pharmacist | 8700 Beverly Blvd, West Hollywood, CA 90048-1804 | 2020-07-06 |
| 1992322200 | Kessia Reis | Nurse Anesthetist, Certified Registered | 8700 Beverly Blvd, West Hollywood, CA 90048-1804 | 2020-07-02 |
| 1154947695 | Prime 5 Medical Group Inc | Hospitalist | 8700 Beverly Blvd, West Hollywood, CA 90048-1804 | 2020-06-21 |
| 1770108672 | Pegah Panirian | Podiatrist | 8700 Beverly Blvd, West Hollywood, CA 90048-1804 | 2020-06-16 |
| 1891310934 | Steven Heer | Student in an Organized Health Care Education/Training Program | 8700 Beverly Blvd, West Hollywood, CA 90048-1804 | 2020-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609473420 | Alden Advanced Surgicenter LLC | Clinic/Center | 8741 Alden Drive, Suite B, Los Angeles, CA 90048 | 2020-10-05 |
| 1760090062 | New Dawn Tms Psychiatry | Clinic/Center | 640 S San Vincente Blvd, Ste. 210, Los Angeles, CA 90048 | 2020-07-22 |
| 1114547312 | Savannah Marie Gonzales | Student in an Organized Health Care Education/Training Program | 8700 Beverly Blvd Suite 3636, Los Angeles, CA 90048 | 2020-04-17 |
| 1861048613 | Sam Dawkins | Internal Medicine | Suite 415e, 8631 West Third Street, Los Angeles, CA 90048 | 2019-08-16 |
| 1295202638 | Caleb Rogers Penn | Anesthesiology | Cedars-sinai Department of Anesthesiology, 8700 Beverly Blvd, Los Angeles, CA 90048 | 2018-10-24 |
| 1437641727 | Medical Imaging Center of Southern California-beverly Hills, Inc | Radiology | 8727 Beverly Blvd, Los Angeles, CA 90048 | 2018-06-01 |
| 1689164121 | Maulin Shah | Student in an Organized Health Care Education/Training Program | 8700 Beverly Blvd Suite 5512, Los Angeles, CA 90048 | 2018-05-10 |
| 1013423631 | Abdul Ali Qaderi | Anesthesiology | 8700 Beverly Blvd Suite 4209, Los Angeles, CA 90048 | 2017-12-19 |
| 1619483559 | Sakeenah Hakim | Social Worker | 292 S. La Cienega Blvd, Suite 102, Los Angeles, CA 90048 | 2017-12-14 |
| 1851805048 | West Hollywood Medical Group Inc | General Practice | 8733 Beverly Blvd Suite #203, West Hollywood, CA 90048 | 2017-11-27 |
| Find all providers in zip 90048 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194325084 | Rimma R Golub | Nurse Practitioner | 948 N. Fairfax Ave, Suite 201, West Hollywood, CA 90046 | 2020-10-29 |
| 1477101509 | Elizabeth Danielle Jaramillo | Nurse Practitioner | 7551 Norton Ave Apt 4, West Hollywood, CA 90046-5522 | 2019-09-02 |
| 1639631567 | Alyssa N Debellis | Nurse Practitioner | 8900 Beverly Blvd Ste 250, West Hollywood, CA 90048-2438 | 2019-04-01 |
| 1992144489 | Virginia Denise Hall | Nurse Practitioner | 8570 W Sunset Blvd Ste 1.5, West Hollywood, CA 90069 | 2013-06-18 |
| 1285241919 | Jannisen Hwang | Nurse Practitioner | 310 N San Vicente Blvd, West Hollywood, CA 90048-1810 | 2020-09-27 |
| 1780299909 | Anne Bosslet | Nurse Practitioner | 8491 Santa Monica Blvd, West Hollywood, CA 90069-4218 | 2020-09-14 |
| 1336773332 | Anna Gallagher | Nurse Practitioner | 8900 Beverly Blvd, West Hollywood, CA 90048-2438 | 2020-02-28 |
| 1467099283 | Ruth Liao Pigeon | Nurse Practitioner | 8733 Beverly Blvd Ste 306, West Hollywood, CA 90048-1843 | 2019-12-01 |
| 1902465297 | Lini Thomas | Nurse Practitioner | 8700 Beverly Blvd, West Hollywood, CA 90048-1804 | 2019-06-10 |
| 1992269427 | Adam Joseph Aisner | Nurse Practitioner | 8491 Santa Monica Blvd, West Hollywood, CA 90069-4218 | 2019-01-29 |
| Find all providers in WEST HOLLYWOOD | ||||
| City | WEST HOLLYWOOD |
| Zip Code | 90048 |
Please comment or provide details below to improve the information on MS. COLLEEN DELORES 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.