KRISTEEN RENEE JACKSON (NPI# 1679117535) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679117535 |
| Entity Type | Individual |
| Full Name | KRISTEEN RENEE JACKSON |
| Practice Address |
5311 S Western Ave Los Angeles CA 90062-2703 |
| Practice Telephone | 3235700445 |
| Mailing Telephone | 3235700445 |
| Enumeration Date | 2019-11-04 |
| Last Update Date | 2019-11-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers |
| Street Address |
5311 S WESTERN AVE |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90062-2703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689797995 | New Beginnings Recovery Treatment Center, Inc. | Substance Abuse Rehabilitation Facility | 5311 S Western Ave, Los Angeles, CA 90062-2703 | 2007-04-10 |
| 1568089886 | Iris Cohen | Counselor | 5311 S Western Ave, Los Angeles, CA 90062-2703 | 2020-07-02 |
| 1649816810 | Dion Smith | Counselor | 5311 S Western Ave, Los Angeles, CA 90062-2703 | 2019-11-22 |
| 1417598442 | Nicole Ann Kindle | Counselor | 5311 S Western Ave, Los Angeles, CA 90062-2703 | 2019-10-01 |
| 1750938569 | Jenice Scurlark | Case Manager/Care Coordinator | 5311 S Western Ave, Los Angeles, CA 90062-2703 | 2019-08-26 |
| 1952954422 | Phylicia Tillett | Case Manager/Care Coordinator | 5311 S Western Ave, Los Angeles, CA 90062-2703 | 2019-07-23 |
| 1154897049 | Joshua Javedanfar | Counselor | 5311 S Western Ave, Los Angeles, CA 90062-2703 | 2018-10-17 |
| 1023592920 | Beatriz Julia Martinez | Case Manager/Care Coordinator | 5311 S Western Ave, Los Angeles, CA 90062-2703 | 2018-09-18 |
| 1467950238 | Dianna Rodriguez | Counselor | 5311 S Western Ave, Los Angeles, CA 90062-2703 | 2018-01-26 |
| 1689043762 | Sonya Groomes | Case Manager/Care Coordinator | 5311 S Western Ave, Los Angeles, CA 90062-2703 | 2015-09-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386298867 | Prompt Healthcare, Inc., A Medical Corporation | Family Medicine | 1972 West 48th Street, #a, Los Angeles, CA 90062 | 2019-08-01 |
| 1083194773 | Day One Detox Center, Inc | Substance Abuse Rehabilitation Facility | 1421 W 46th St, Los Angeles, CA 90062 | 2018-08-21 |
| 1457863706 | The Dream Catcher Foundation, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1537 W 49th St, Los Angeles, CA 90062 | 2017-10-26 |
| 1639680259 | The Dream Catcher Foundation, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1762 W 42nd St, Los Angeles, CA 90062 | 2017-10-23 |
| 1033535794 | Trusana Monique Hall | Licensed Vocational Nurse | 4103 S. Halldale Ave, Los Angeles, CA 90062 | 2014-03-05 |
| 1093139644 | Daniel Garcia | Rehabilitation Practitioner | 3381 Western Ave., Los Angeles, CA 90062 | 2014-02-18 |
| 1689003790 | Crystal Vernon | Case Manager/Care Coordinator | 3881 S. Western Avenue, Los Angeles, CA 90062 | 2013-11-08 |
| 1184902934 | Gerry Lynn Lockhart | Case Manager/Care Coordinator | 3881 S Western Avenue, Los Angeles, CA 90062 | 2011-07-28 |
| 1285921692 | Atlantic Recovery Services | Community/Behavioral Health | 1701 Browning Street, Los Angeles, CA 90062 | 2011-07-06 |
| 1174796452 | Tacora Leggett | Counselor | 5311 S Western Avenue, Los Angeles, CA 90062 | 2008-04-08 |
| Find all providers in zip 90062 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194326645 | Jamie Bracco | Marriage & Family Therapist | 564 Lillian Way, Los Angeles, CA 90004-1106 | 2020-11-02 |
| 1174123160 | Namita Individual Family and Child Therapists & Associates, Inc. | Marriage & Family Therapist | 357 S Curson Ave # 47-4e, Los Angeles, CA 90036-5201 | 2020-10-28 |
| 1972103398 | Vera Mae Rodriguez | Marriage & Family Therapist | 124 N Townsend Ave, Los Angeles, CA 90063-2334 | 2020-10-26 |
| 1639778319 | Ep Marriage Therapy, Inc. | Marriage & Family Therapist | 504 S Normandie Ave Apt 105, Los Angeles, CA 90020-3023 | 2020-10-22 |
| 1306445499 | Maythal H Eshaghian | Marriage & Family Therapist | 100 N Wetherly Dr Apt 2d, Los Angeles, CA 90048-1833 | 2020-10-20 |
| 1134727597 | Barbara K. Polland | Marriage & Family Therapist | 10533 Rountree Rd., Los Angeles, CA 90064 | 2020-10-16 |
| 1528666005 | Paul Felipe Estopier | Marriage & Family Therapist | 3630 Marathon St Apt 318, Los Angeles, CA 90026-2869 | 2020-10-15 |
| 1245837970 | Catherine Pancheri | Marriage & Family Therapist | 616 N Curson Ave, Los Angeles, CA 90036-1812 | 2020-10-06 |
| 1003423500 | Rachel Goldstein | Marriage & Family Therapist | 11700 National Blvd # L129, Los Angeles, CA 90064-3669 | 2020-09-28 |
| 1326655473 | Robert A Garcia | Marriage & Family Therapist | 515 E 9th St, Los Angeles, CA 90015-1817 | 2020-09-23 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90062 |
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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.