TAKESHA L JACKSON (NPI# 1316569593) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316569593 |
| Entity Type | Individual |
| Full Name | TAKESHA L JACKSON |
| Practice Address |
9398 Rainbow Falls Way Elk Grove CA 95624-1262 |
| Practice Telephone | 9168212541 |
| Mailing Telephone | 9168212541 |
| Enumeration Date | 2020-05-11 |
| Last Update Date | 2020-05-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 171M00000X | 05 |
| Street Address |
9398 RAINBOW FALLS WAY |
| City | ELK GROVE |
| State | CA |
| Zip Code | 95624-1262 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194363721 | Sanam Adela Baidar | Behavior Technician | 9170 Dino Dr, Ste 170, Elk Grove, CA 95624 | 2019-12-13 |
| 1134686041 | Hannah Marie Hamm | Behavior Technician | 9701 Dino Drive, Suite 170, Elk Grove, CA 95624 | 2019-02-27 |
| 1538624259 | Amnah Sattar | Assistant Behavior Analyst | 9701 Dino Dr, Elk Grove, CA 95624 | 2019-02-06 |
| 1740793470 | Sheena Maharaj | Marriage & Family Therapist | 9008 Elk Grove Blvd Ste 11, Elk Grove, CA 95624 | 2017-11-16 |
| 1598285595 | Jessica Russo | Behavior Technician | 8672 Cycladic Ct, Elk Grove, CA 95624 | 2017-06-21 |
| 1982137568 | Jamie Kofoed | Behavioral Analyst | 9355 E Stockton Blvd Ste 100, Elk Grove, CA 95624 | 2017-04-10 |
| 1154878742 | Dorian Elaine Buckner | Counselor | 9355 E. Stockton Blvd., Elk Grove, CA 95624 | 2016-09-01 |
| 1447635529 | David Johnson | Student in an Organized Health Care Education/Training Program | 9666 Kent St, Elk Grove, CA 95624 | 2015-07-30 |
| 1760862437 | Harpreet Singh | Student in an Organized Health Care Education/Training Program | 8617 Orison Ct, Elk Grove, CA 95624 | 2015-06-08 |
| 1942698253 | Noah Shapiro | Social Worker | 9140 Bradshaw Rd, Elf Grove, CA 95624 | 2015-01-08 |
| Find all providers in zip 95624 | ||||
| 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 |
|---|---|---|---|---|
| 1932709359 | Vue Moua | Case Manager/Care Coordinator | 4812 Conzelman Way, Elk Grove, CA 95757-2508 | 2020-10-26 |
| 1295351609 | Jawad Raif | Case Manager/Care Coordinator | 7701 Chappelle Way, Elk Grove, CA 95757-1678 | 2020-06-22 |
| 1598277246 | Eric Stone | Case Manager/Care Coordinator | 8912 Bear Park Ct, Elk Grove, CA 95758-6239 | 2017-11-02 |
| 1275082521 | Felicia Thomas | Case Manager/Care Coordinator | 9214 Fife Ranch Way, Elk Grove, CA 95624-3574 | 2016-09-28 |
| 1922551340 | Louie Lomibao | Case Manager/Care Coordinator | 9262 Louis St, Elk Grove, CA 95624-3586 | 2016-08-02 |
| 1093268716 | Gregorio Castellano Sabio X | Case Manager/Care Coordinator | 9204 Rainbow Creek Way, Elk Grove, CA 95624-4814 | 2016-07-28 |
| 1043630973 | Solomon A Smith | Case Manager/Care Coordinator | 5820 Fire Poppy Dr, Elk Grove, CA 95757-2848 | 2014-04-17 |
| 1134568223 | Onesimo Garcia | Case Manager/Care Coordinator | 8611 Elk Ridge Way, Elk Grove, CA 95624-2259 | 2013-06-21 |
| 1134303779 | Ravinder Singh | Case Manager/Care Coordinator | 6705 Peninsula Way, Elk Grove, CA 95758-6282 | 2007-12-18 |
| 1558540799 | David Wayne Brannon | Case Manager/Care Coordinator | 8958 Forked Creek Way, Elk Grove, CA 95758-5732 | 2007-10-24 |
| Find all providers in ELK GROVE | ||||
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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.