ERICA R JACKSON (NPI# 1174179980) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174179980 |
| Entity Type | Individual |
| Full Name | ERICA R JACKSON |
| Practice Address |
11355 Desmond St Garden Grove CA 92841 |
| Practice Telephone | 2283570974 |
| Enumeration Date | 2019-08-16 |
| Last Update Date | 2019-08-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747A0650X |
Technician Specialization: Attendant Care Provider |
Nursing Service Related Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710596978 | Erica Lakisha Jackson | Occupational Therapist | 212 Fairview Park Dr, Dublin, GA 31021-2547 | 2020-07-23 |
| 1528672680 | Erica Paige Jackson | Pharmacist | 250 Mount Lebanon Blvd, Pittsburgh, PA 15234-1252 | 2020-09-04 |
| 1679122824 | Erica Lynn Jackson | Physical Therapist | 15825 Ballantyne Medical Pl Ste 120, Charlotte, NC 28277-4790 | 2019-09-10 |
| 1558916577 | Erica Jackson | Driver | 861 Corporate Dr Ste 101, Lexington, KY 40503-5461 | 2019-08-06 |
| 1912471442 | Erica Chavez Jackson | Case Manager/Care Coordinator | 6666 Green Valley Cir, Culver City, CA 90230-7068 | 2019-01-17 |
| 1699245571 | Erica Jackson | Case Manager/Care Coordinator | 1055 S Houston Ave, Tulsa, OK 74127-9043 | 2018-12-04 |
| 1245725050 | Erica L Jackson | Behavior Technician | 1800 W Big Beaver Rd, Troy, MI 48084-3545 | 2018-06-25 |
| 1518384817 | Erica Marie Jackson | Specialist | 814 Shanahan Rd Ste 100, Lewis Center, OH 43035-9192 | 2014-03-25 |
| 1962639070 | Erica Lynnette Jackson | Counselor | 1371 Highway 278 W, Monticello, AR 71655-9663 | 2009-06-16 |
| 1437393345 | Erica Christian Jackson | Speech-Language Pathologist | 2730 Isabella Blvd, Suite 10, Jacksonville Beach, FL 32250-8001 | 2009-04-22 |
| Street Address |
11355 DESMOND ST |
| City | GARDEN GROVE |
| State | CA |
| Zip Code | 92841 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184107500 | Tat Pharmacy, Inc | Pharmacy | 9153 Garden Grove Blvd., Garden Grove, CA 92841 | 2018-09-11 |
| 1083119002 | Hoang Dmd Dental Inc. | Dentist | 9639 Chapman Ave, Garden Grove, CA 92841 | 2018-03-30 |
| 1699282434 | Rubi Esmeralda Tapia | Social Worker | 7441 Lincoln Way Ste 250, Garden Grove, CA 92841 | 2018-01-02 |
| 1144739830 | Bryan Nguyen | Spec/Tech, Health Info | 9862 Chapman Ave., Ste. B, Garden Grove, CA 92841 | 2017-09-25 |
| 1649796111 | Jesus Torres | Case Manager/Care Coordinator | 9862 Chapman Ave Suite B, Garden Grove, CA 92841 | 2017-08-16 |
| 1477005312 | Naincee Tolani | Occupational Therapist | 12881 Knott Street, Suite 103, Garden Grove, CA 92841 | 2016-10-26 |
| 1114385838 | Quyen Do | Case Manager/Care Coordinator | 9862 Chapman Ave, Ste. B, Garden Grove, CA 92841 | 2016-02-09 |
| 1629331657 | Superior Medical Management, LLC | Clinic/Center | 9862 Lemore Drive, Garden Grove, CA 92841 | 2012-06-25 |
| 1376818344 | Meghan Lyyn-deibert Pickens | Behavioral Analyst | 7291 Garden Grove Blvd. Suite F, Garden Grove, CA 92841 | 2012-03-09 |
| 1457625295 | Robert Douk | Psychologist | 11358 Knott St., Garden Grove, CA 92841 | 2012-02-24 |
| Find all providers in zip 92841 | ||||
| Taxonomy Code | 3747A0650X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Attendant Care Provider |
| An individual who provides hands-on care, of both a supportive and health related nature, specific to the needs of a medically stable, physically handicapped individual. Supportive services are those that substitute for the absence, loss, diminution, or impairment of a physical or cognitive function. This service may include skilled or nursing care to the extent permitted by state law. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245881291 | Denice Gail Hess I | Technician | 12071 Reva Dr, Garden Grove, CA 92840-2626 | 2019-09-21 |
| 1568019412 | Aracely Todd | Technician | 12822 Sungrove St, Garden Grove, CA 92840-6543 | 2019-08-23 |
| 1962059352 | Maria Sanchez Selvas | Technician | 5922 Belgrave Ave, Garden Grove, CA 92845 | 2019-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700487691 | Hine Maumalanga | Technician | 1094 Folsom Ave, Hayward, CA 94544-5704 | 2020-11-05 |
| 1649871765 | Charles Leroy Appleberry II | Technician | 1100 S Chester Ave, Compton, CA 90221-4312 | 2020-11-04 |
| 1902407174 | Ryan Allen Merrell | Technician | 313 E. 17th Pl #l Costa Mesa, Costa Mesa, CA 92627 | 2020-11-04 |
| 1083212476 | Christina Elisabeth Brunn | Technician | 2818 Huxley Pl, Fremont, CA 94555-1416 | 2020-10-16 |
| 1790392165 | Amanda Moore | Technician | 6445 Village Center Dr, Building 7 Apt 101, Sacramento, CA 95823 | 2020-09-29 |
| 1730795543 | Corina Rochelle Burch | Technician | 3706 Calavo Dr, Spring Valley, CA 91977-1903 | 2020-09-17 |
| 1033724729 | Cinta Latrece Moore | Technician | 12329 Creekview Dr Unit 37, San Diego, CA 92128-6624 | 2020-09-10 |
| 1598379398 | Trina Diane Brown | Technician | 115 W Zane St, Long Beach, CA 90805-6327 | 2020-08-31 |
| 1437760766 | Jeri Lyn Allen-smith | Technician | 9228 Allano Way, Santee, CA 92071-2202 | 2020-08-11 |
| 1750991667 | Natalie Mari Norman | Technician | 5013 Englewood Dr, San Jose, CA 95129-4232 | 2020-08-05 |
| Find all providers with the same taxonomy | ||||
| City | GARDEN GROVE |
| Zip Code | 92841 |
Please comment or provide details below to improve the information on ERICA R 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.