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NPI Code Detail

MEDICARE: CHRISTOPHER JACKSON

MEDICARE:   CHRISTOPHER  JACKSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker124000CA

General Provider Information

NPI Number : 1346018959
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER JACKSON
Provider Business Mailing Address
First Line : 3703 VOLK AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90808-2350
Country : US
Telephone Number : 310-869-1156
Fax Number :
Provider Business Practice Location Address
First Line : 3703 VOLK AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90808-2350
Country : US
Telephone Number : 310-869-1156
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2023
Last Update Date : 04/14/2026

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Directions to “ CHRISTOPHER JACKSON ” Practice Location

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