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).
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 |
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 |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | 7068 | 05 | |
CA | 6758 | 05 | |
CA | 7420 | 05 |
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 |
Street Address |
851 N OAKLAND AVE |
City | PASADENA |
State | CA |
Zip Code | 91104-4343 |
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 |
Find all providers in the same location |
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 |
Find all providers in zip 91104 |
Taxonomy Code | 390200000X |
Grouping | Student, Health Care |
Classification | Student in an Organized Health Care Education/Training Program |
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] |
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 |
Find all providers in PASADENA |
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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.