CHANEL D JACKSON (NPI# 1205492279) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205492279 |
| Entity Type | Individual |
| Full Name | CHANEL D JACKSON |
| Practice Address |
1355 S Hill St Los Angeles CA 90015-3012 |
| Mailing Address |
550 S Vermont Ave Rm 904 Los Angeles CA 90020-1912 |
| Practice Telephone | 2133895820 |
| Mailing Telephone | 2137384775 |
| Mailing Fax Number | 2136325892 |
| Enumeration Date | 2019-05-15 |
| Last Update Date | 2019-05-15 |
| 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 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3455 Percy St, Los Angeles, CA 900231716 | 3232682100 | |
| 437 N Hoover St, Los Angeles, CA 900042306 | 3236660705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710409552 | Chanel R Jackson | Technician | 1471 Howard Rd Se, Washington, DC 20020-4493 | 2017-07-13 |
| 1659815637 | Chanel Jackson | Home Health Aide | 93 W Glendale St, Bedford, OH 44146-3273 | 2016-12-11 |
| Street Address |
1355 S HILL ST |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90015-3012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255506655 | Lilia Sheynman | Counselor | 1355 S Hill St, Los Angeles, CA 90015-3012 | 2008-04-25 |
| 1730798257 | Frankie Michael La Fuente | Student in an Organized Health Care Education/Training Program | 1355 S Hill St, Los Angeles, CA 90015-3012 | 2020-07-30 |
| 1013526086 | Laronya Farrar | Rehabilitation Counselor | 1355 S Hill St, Los Angeles, CA 90015-3012 | 2020-07-27 |
| 1366081895 | Marshall Buckley Fryman | Student in an Organized Health Care Education/Training Program | 1355 S Hill St, Los Angeles, CA 90015-3012 | 2020-01-01 |
| 1033758719 | Angela Kim Garland | Rehabilitation Counselor | 1355 S Hill St, Los Angeles, CA 90015-3012 | 2019-12-30 |
| 1013565761 | Gabriela Anahi Leon | Rehabilitation Practitioner | 1355 S Hill St, Los Angeles, CA 90015-3012 | 2019-08-27 |
| 1639726789 | Diana Frias | Rehabilitation Practitioner | 1355 S Hill St, Los Angeles, CA 90015-3012 | 2019-08-22 |
| 1003461575 | Shannon Mckinnon | Marriage & Family Therapist | 1355 S Hill St, Los Angeles, CA 90015-3012 | 2019-08-01 |
| 1235783929 | Anthony Manuel Chavira | Student in an Organized Health Care Education/Training Program | 1355 S Hill St, Los Angeles, CA 90015-3012 | 2019-07-30 |
| 1831753847 | Jacob Joseph Aaron Rostovsky | Marriage & Family Therapist | 1355 S Hill St, Los Angeles, CA 90015-3012 | 2019-04-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184224156 | Via Care Community Health Center | Clinic/Center | 400 West Washington Blvd., The Hub D3-room 107, Los Angeles, CA 90015 | 2020-10-29 |
| 1225650955 | Luis Alvarado | Student in an Organized Health Care Education/Training Program | 1150 S. Olive Street, Suite 1400, Los Angeles, CA 90015 | 2020-05-15 |
| 1386290385 | Amy M Powell | Student in an Organized Health Care Education/Training Program | 1140 S.olive Street Ste #1427, Los Angeles, CA 90015 | 2019-08-15 |
| 1881170199 | Angie Andreina Trias Sanchez | Student in an Organized Health Care Education/Training Program | 936 S Olive St Apt 154, Los Angeles, CA 90015 | 2018-07-19 |
| 1083148753 | Central Neighborhood Health Foundation - Fontana | Clinic/Center | 714 W. Olympic Blvd Suite # 801, Los Angeles, CA 90015 | 2017-04-19 |
| 1255871711 | Ethan Lin | Student in an Organized Health Care Education/Training Program | 1401 S. Grand Ave. Suite 101, Residency Program, Los Angeles, CA 90015 | 2017-03-03 |
| 1972055093 | Yvonne Perez | Social Worker | 1150 South Hill St, Suite H-375, Los Angeles, CA 90015 | 2016-10-25 |
| 1356896492 | Mayano Ochi | Midwife | 1513 S Grand Ave Ste 250, Los Angeles, CA 90015 | 2016-08-18 |
| 1518321686 | Cielo Reyna-donaldson | Registered Nurse | 1520 South Olive Street, Los Angeles, CA 90015 | 2016-04-05 |
| 1891175774 | Amanecer Community Counseling Service | Community/Behavioral Health | 1500 S Olive St Rm 506, Los Angeles, CA 90015 | 2015-06-04 |
| Find all providers in zip 90015 | ||||
| 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 | 90015 |
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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.