MR. LANCE RONALD JACKSON SR.


Address: 851 N Oakland Ave, Pasadena, CA 91104-4343
Phone: 6263957100

MR. LANCE RONALD JACKSON SR. (NPI# 1548581416) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1548581416
Entity Type Individual
Full Name MR. LANCE RONALD JACKSON SR.
Practice Address 851 N Oakland Ave
Pasadena
CA 91104-4343
Practice Telephone 6263957100
Mailing Telephone 6263957100
Mailing Fax Number 8188965069
Enumeration Date 2010-06-15
Last Update Date 2020-01-23
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 225400000X Rehabilitation Practitioner CA Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Y 390200000X Student in an Organized Health Care Education/Training Program Student, Health Care

Other Provider Identifier

State Issuer Identifier Type Code
CA 7068 05
CA 6758 05
CA 7420 05

Other Providers LANCE JACKSON

NPI Name Taxonomy Address Enumeration
1205154036 Lance Duane Jackson Chiropractor 4616 Broadway St Ste B, Pearland, TX 77581-3954 2010-05-04
1174554521 Lance Elliot Jackson Specialist 18518 Hardy Oak, Suite 300, San Antonio, TX 78258-4271 2006-07-05
1346882123 Lance Jackson Behavior Technician 2400 E Katella Ave Ste 800, Anaheim, CA 92806-5955 2019-10-12
1053741926 Lance Jackson Counselor 7360 Coral Way, Suite #23b, Miami, FL 33155-1498 2013-11-13

Office Location

Street Address 851 N OAKLAND AVE
City PASADENA
State CA
Zip Code 91104-4343

Providers in the same location

NPI Name Taxonomy Address Enumeration
1932230331 Paul T. Gibson Rehabilitation Practitioner 851 N Oakland Ave, Pasadena, CA 91104-4343 2007-03-08
1124678438 Kristina Navarro Social Worker 851 N Oakland Ave, Pasadena, CA 91104-4343 2019-09-18
1215304134 Moira Helena Williams Social Worker 851 N Oakland Ave, Pasadena, CA 91104-4343 2015-08-26
1447626163 Alana Marie Gallardo Marriage & Family Therapist 851 N Oakland Ave, Pasadena, CA 91104-4343 2015-08-17
1356771836 Rajilakshmi Shivshanker Social Worker 851 N Oakland Ave, Pasadena, CA 91104-4343 2013-11-19
1033454004 Monica Ann Bates Marriage & Family Therapist 851 N Oakland Ave, Pasadena, CA 91104-4343 2012-12-03
1386989481 Daphne Michelle Drake Marriage & Family Therapist 851 N Oakland Ave, Pasadena, CA 91104-4343 2012-11-30
1801149596 Laura G Romero Rehabilitation Practitioner 851 N Oakland Ave, Pasadena, CA 91104-4343 2012-10-18
1962799312 Lorena Flores Marriage & Family Therapist 851 N Oakland Ave, Pasadena, CA 91104-4343 2011-07-06
1710204102 Gretchen Whitfield Rehabilitation Practitioner 851 N Oakland Ave, Pasadena, CA 91104-4343 2010-04-26
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1093284382 Jack Lee Johnson II Counselor 1680 North Fair Oaks, Pasadena, CA 91104 2018-11-16
1699257055 Aqueelah Russell Lactation Consultant, Non-RN 855 N. Catalina Ave, Pasadena, CA 91104 2018-09-02
1053893529 Jordann Ashley Stewart Case Manager/Care Coordinator 691 East Washington Blvd, Pasadena, CA 91104 2018-08-31
1942789706 Elmer Caballero Case Manager/Care Coordinator 691 E Washington Blvd, Pasadena, CA 91104 2018-08-12
1649759648 Orlando Javier Sava Jr. Case Manager/Care Coordinator 1395 E. Orange Grove Blvd, Pasadena, CA 91104 2018-08-09
1669923611 Grandview Foundation, Inc. Substance Abuse Rehabilitation Facility 225 Grandview Street, Pasadena, CA 91104 2016-10-14
1255734166 Linhua Wang-kim Massage Therapist 1028 N. Lake Ave., Suite 108c, Pasadena, CA 91104 2014-10-06
1477893782 Med Tec Diagnostic Inc. Clinic/Center 1310 N. Mar Vista Unit 3, Pasadena, CA 91104 2013-02-22
1750631321 Gordon Sheldall Marriage & Family Therapist 1495 N Lake Avenue, Pasadena, CA 91104 2012-09-11
1699024521 Sherry Lynn Wait Marriage & Family Therapist 1495 N. Lake Ave., Pasadena, CA 91104 2012-09-06
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Taxonomy Information

Taxonomy Code 390200000X
Grouping Student, Health Care
Classification Student in an Organized Health Care Education/Training Program

Taxonomy Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Notes: [1/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1245837558 Carol Luree Eckerl Student in an Organized Health Care Education/Training Program 673 Cedar Dr, Pasadena, MD 21122-4450 2020-10-08
1902420227 Scott Robert Henderson Student in an Organized Health Care Education/Training Program Kaiser Permanente Bernard J. Tyson School of Me, 98 S. Los Robles Avenue, Pasadena, CA 91101-9110 2020-06-02
1467076869 Tong Qi Student in an Organized Health Care Education/Training Program Kaiser Permanente Bernard Kj. Tyson School of Medicine, Pasadena, CA 91101 2020-06-01
1386267839 Kelly B Shriver Student in an Organized Health Care Education/Training Program Kaiser Permanente Bernard J. Tyson School of Medicine, 98 S. Los Robles, Pasadena, CA 91101 2020-05-19
1659906469 Danielle Elisa Cook Student in an Organized Health Care Education/Training Program 1370 Old Water Oak Point Rd, Pasadena, MD 21122-2300 2020-03-12
1750933511 Andrew Long Student in an Organized Health Care Education/Training Program 1632 Concordia Dr, Pasadena, MD 21122-6008 2019-07-11
1336791375 Jianyin Li Student in an Organized Health Care Education/Training Program 100 W Wanut Street Suite 375, Pasadena, CA 91124-0001 2019-07-10
1669034039 Mai Nojima Student in an Organized Health Care Education/Training Program 98 S Los Robles Ave, Pasadena, CA 91101-2433 2019-07-05
1912569997 Katelyn Marie George Student in an Organized Health Care Education/Training Program 8028 Ritchie Hwy Ste 120, Pasadena, MD 21122-1069 2019-07-01
1427534767 Susanna Sackitey Student in an Organized Health Care Education/Training Program 280 S Euclid Ave Apt 102, Pasadena, CA 91101-2760 2018-07-18
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Competitor

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City PASADENA
Zip Code 91104

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Dataset Information

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.

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