KENT R JACKSON (NPI# 1871660613) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871660613 |
| Entity Type | Individual |
| Full Name | KENT R JACKSON |
| Credential | MD |
| Practice Address |
25825 Vermont Ave Harbor City CA 90710-3518 |
| Practice Telephone | 3103255111 |
| Mailing Telephone | 3103255111 |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2008-09-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204D00000X | Neuromusculoskeletal Medicine & OMM | A78820 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841857398 | Kent Jackson | Behavior Technician | 27777 Inkster Rd Ste 100, Farmington Hills, MI 48334-5326 | 2019-05-21 |
| Street Address |
25825 VERMONT AVE |
| City | HARBOR CITY |
| State | CA |
| Zip Code | 90710-3518 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578567178 | Jennifer Diane Armstrong | Internal Medicine | 25825 Vermont Ave, Harbor City, CA 90710-3518 | 2005-06-10 |
| 1972118263 | Mitos Rachel Roa Daling | Registered Nurse | 25825 Vermont Ave, Harbor City, CA 90710-3518 | 2020-09-13 |
| 1689285884 | Sarah Gong | Pharmacist | 25825 Vermont Ave, Harbor City, CA 90710-3518 | 2020-08-11 |
| 1578172607 | Daisy Lee | Pharmacist | 25825 Vermont Ave, Harbor City, CA 90710-3518 | 2020-07-24 |
| 1114558897 | David Seho Park | Pharmacist | 25825 Vermont Ave, Harbor City, CA 90710-3518 | 2020-01-30 |
| 1801446208 | Pamela Barron-zambrano | Nurse Anesthetist, Certified Registered | 25825 Vermont Ave, Harbor City, CA 90710-3518 | 2019-09-17 |
| 1760030076 | Tajmara Ismail | Respiratory Therapist, Registered | 25825 Vermont Ave, Harbor City, CA 90710-3518 | 2019-08-29 |
| 1518513423 | Alexa Ann Pepin | Dietitian, Registered | 25825 Vermont Ave, Harbor City, CA 90710-3518 | 2019-08-15 |
| 1184279119 | Martin Lavertu | Registered Nurse | 25825 Vermont Ave, Harbor City, CA 90710-3518 | 2019-08-06 |
| 1417515073 | Ulises Obregon | Respiratory Therapist, Registered | 25825 Vermont Ave, Harbor City, CA 90710-3518 | 2019-05-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164036018 | Eddie Blackmon IIi | Respiratory Therapist, Registered | 25820 Normandie Ave, Harbor City, CA 90710 | 2020-09-08 |
| 1316502099 | Jennifer Ilene Estey | Nurse Practitioner | 1403 Lomita Blvd Ste 307, Harbor City, CA 90710 | 2019-05-07 |
| 1104398643 | Active Life Home Care Inc | In Home Supportive Care | 760 W. Lomita Blvd., Suite 79, Harbor City, CA 90710 | 2018-12-21 |
| 1073088514 | Ez Access Transportation Corp. | Non-emergency Medical Transport (VAN) | 24328 S Vermont Ave, Suite #313, Harbor City, CA 90710 | 2018-10-11 |
| 1689192791 | County of Los Angeles Auditor Controller | Clinic/Center | 1403 Lomita Blvd., Suite 102, Rooms 1-26 & Conference Room, Harbor City, CA 90710 | 2017-09-08 |
| 1174041347 | Cb Carehome, Inc | Skilled Nursing Facility | 23331 Maltby Place, Harbor City, CA 90710 | 2017-09-07 |
| 1649705682 | Gina Guillaume | Student in an Organized Health Care Education/Training Program | 1403 West Lomita Blvd Suite 200, Harbor City, CA 90710 | 2017-04-27 |
| 1760843213 | Karen Savoni | Social Worker | 25975 Normandie Avenue, Harbor City, CA 90710 | 2016-03-11 |
| 1699148593 | Kaiser Permanente | Health Maintenance Organization | 25965 S. Normandie Aveune, Harbor City, CA 90710 | 2015-11-02 |
| 1164778148 | Thermon Lenelle Carrier | Driver | 1332 W. 254th St, Apt E, Harbor City, CA 90710 | 2012-07-27 |
| Find all providers in zip 90710 | ||||
| Taxonomy Code | 204D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neuromusculoskeletal Medicine & OMM |
| The Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician directs special attention to the neuromusculoskeletal system and its interaction with other body systems. Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine, and integrates each of these into the management of pediatric, adolescent, adult, and geriatric patients. |
| Notes: Source: American Osteopathic Association, 2017 [7/1/2017: added definition] - Additional Resources: American Osteopathic Board of Neuromusculoskeletal Medicine, 2017, http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063571651 | David Ron Anderson | Neuromusculoskeletal Medicine & OMM | 25825 Vermont Ave, Harbor City, CA 90710-3518 | 2006-12-08 |
| 1245307461 | John A. Peters | Neuromusculoskeletal Medicine & OMM | 25825 Vermont Ave, Harbor City, CA 90710-3518 | 2006-11-30 |
| 1861569675 | Jacob M. Ishkanian | Neuromusculoskeletal Medicine & OMM | 25825 Vermont Ave, Harbor City, CA 90710-3518 | 2006-11-29 |
| 1366519290 | Ronald A. Navarro | Neuromusculoskeletal Medicine & OMM | 25825 Vermont Ave, Harbor City, CA 90710-3518 | 2006-11-29 |
| 1104997162 | Anthony J. Leone | Neuromusculoskeletal Medicine & OMM | 25825 Vermont Ave, Harbor City, CA 90710-3518 | 2006-11-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144860743 | Roeshan Shadravan | Neuromusculoskeletal Medicine & OMM | 1505 Lomas Santa Fe Dr, Solana Beach, CA 92075-2103 | 2020-01-11 |
| 1548722416 | R. Mitchell Hiserote Do, Professional Corporation | Neuromusculoskeletal Medicine & OMM | 7064 Corline Ct Ste C1, Sebastopol, CA 95472-4528 | 2019-04-01 |
| 1851768899 | Petaluma Acupuncture Center | Neuromusculoskeletal Medicine & OMM | 720 Southpoint Blvd Ste 211, Petaluma, CA 94954-7496 | 2015-08-25 |
| 1063800258 | Kulveen Sachdeva, Md Inc. | Neuromusculoskeletal Medicine & OMM | 5401 Norris Canyon Road, Suite 110, San Ramon, CA 94583-5402 | 2014-12-23 |
| 1982010559 | Walter Jaye Cohen | Neuromusculoskeletal Medicine & OMM | 3706 Ruffin Rd Ste 129, San Diego, CA 92123-1812 | 2014-07-03 |
| 1962815068 | Sunil Bhat | Neuromusculoskeletal Medicine & OMM | 2555 Flores St Ste 395, San Mateo, CA 94403-2344 | 2014-06-05 |
| 1417298811 | Sibyl Knight | Neuromusculoskeletal Medicine & OMM | 199 17th St Ste J, Pacific Grove, CA 93950 | 2013-03-09 |
| 1447597349 | Lee Ann Marie Cuny | Neuromusculoskeletal Medicine & OMM | 1502 Tennessee St, Vallejo, CA 94590-4627 | 2013-01-11 |
| 1285985820 | Annette Hulse | Neuromusculoskeletal Medicine & OMM | 1 1st St Ste 3, Los Altos, CA 94022-2753 | 2012-09-23 |
| 1871853796 | Brian Peternell | Neuromusculoskeletal Medicine & OMM | 584 35th Ave, Santa Cruz, CA 95062-5111 | 2012-05-24 |
| Find all providers with the same taxonomy | ||||
| City | HARBOR CITY |
| Zip Code | 90710 |
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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.