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General NPI Number Information
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NPI Number | 1639859002
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Entity Type | Organization
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Legal Business Name | CNS SERVICES, INC
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Dates
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Enumeration Date | 07/20/2023
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Last Update Date | 09/10/2023
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Provider Practice Location Address
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Address Line | 2309 W RAYMOND ST
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City | COMPTON
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State | CA
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Zip | 90220-4047
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Country | US
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Telephone | 562-338-6087
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Fax |
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Provider Business Mailing Address
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Address Line | 618 W SCHOOL ST
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City | COMPTON
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State | CA
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Zip | 90220-1923
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Country | US
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Telephone | 562-250-4150
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Fax | 562-567-8549
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Authorized Official
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Title or Position | CEO
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Name | SHANNON JACKSON
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Credential | RN
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Telephone | 562-338-6087
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WD0400X
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Taxonomy Name | Diabetes Educator Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 133VN1201X
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Taxonomy Name | Obesity and Weight Management Nutrition Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 405300000X
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Taxonomy Name | Prevention Professional
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 163WC1600X
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Taxonomy Name | Continuing Education/Staff Development Registered Nurse
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License Number |
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License Number State |
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