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CHANELL JACKSON
NPI 1114402492
Social Worker - Clinical in Lynwood, CA

Active since October 02, 2018PECOS EnrolledAccepts Medicare Assignment
3630 E IMPERIAL HWY, LYNWOOD, CA 90262(310) 900-4619 Get Directions Write a Review

NPPES record last updated: March 23, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 23, 2026, Sep 22, 2022, Jul 22, 2021 and 2 more (5 updates tracked since 2018).

About Chanell Jackson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHANELL JACKSON (NPI 1114402492) is an individual clinical provider in Lynwood, California, licensed in California (110237) and active in the NPI registry since October 2018. She is enrolled in Medicare PECOS and is a graduate of University Of Southern California Keck School Of Medicine (2013).

NPPES Registry Identity

NPI1114402492
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameCHANELL JACKSON
Location Address3630 E IMPERIAL HWYLynwood, CA 90262-2609
Mailing Address3630 E Imperial HwyLynwood, CA 90262-2609 · (310) 900-4619
Phone(310) 900-4619
Sole ProprietorNo
Medical School CMSUniversity Of Southern California Keck School Of MedicineGraduated 2013
Enumeration DateOctober 2, 2018
Last NPPES UpdateMarch 23, 20265 updates tracked since enumeration
NPPES CertifiedMarch 23, 2026
✔ NPI 1114402492 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in CA · 110237
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 89545 (CA)
3630 E IMPERIAL HWY, Lynwood, CA 90262
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Chanell Jackson is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3375024870
PECOS Enrollment IDI20260223003236
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Chanell Jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Chris E Esguerra MD PC
177 mi
Multi-Specialty
5750 TRAFFIC WAY STE A
Atascadero, CA 93422
  • Reassigned Medicare billing, California enrollment
  • 9 clinicians in this Medicare group
NPI 1801474598 (855) 378-3361

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90262 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $62.96 – $187.60
Typical copayment $0.00 (range $15.74 – $46.90)
Most-billed visit code NA
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ST. FRANCIS MEDICAL CENTER - CCC
Clinic/Center (Adolescent and Children Mental Health)
3630 E IMPERIAL HWY
LYNWOOD, CA 90262
Los Angeles County (310) 900-8490
DR. NOOR-UL-AIN FATIMA KHAN DNAP, CRNA
Nurse Anesthetist, Certified Registered
3630 E IMPERIAL HWY
LYNWOOD, CA 90262
Los Angeles County (310) 900-8900
DR. GARY NEIL GARSHFIELD MD
Pathology (Anatomic Pathology & Clinical Pathology)
3630 E IMPERIAL HWY
LYNWOOD, CA 90262
Los Angeles County (310) 900-8900
KAREN CHANG MD
Emergency Medicine
3630 E IMPERIAL HWY, EMERGENCY DEPARTMENT
LYNWOOD, CA 90262
Los Angeles County (310) 900-4525
ERIKA C VIRAMONTES MA
Marriage & Family Therapist
3630 E IMPERIAL HWY
LYNWOOD, CA 90262
Los Angeles County (310) 603-6949
ADAM GOLDEN
Surgery (Surgical Critical Care)
3630 E IMPERIAL HWY
LYNWOOD, CA 90262
Los Angeles County (310) 554-4127
RAMESH LAMICHHANE
Student in an Organized Health Care Education/Training Program
3630 E IMPERIAL HWY
LYNWOOD, CA 90262
Los Angeles County (310) 900-8900
ANNA MARIE BAYYA
Registered Nurse (Psychiatric/Mental Health)
3630 E IMPERIAL HWY
LYNWOOD, CA 90262
Los Angeles County (310) 900-8210

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Chanell Jackson's NPI number?

The NPI number for Chanell Jackson is 1114402492. It was assigned to this individual provider in the NPPES registry on October 2, 2018.

Where is Chanell Jackson located?

Chanell Jackson practices at 3630 E Imperial Hwy, Lynwood, CA 90262. The listed phone number is (310) 900-4619.

What is Chanell Jackson's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Chanell Jackson enrolled in Medicare?

Yes. Chanell Jackson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Chanell Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Chanell Jackson reassigns Medicare benefits to Chris E Esguerra MD PC (Atascadero, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Chanell Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Chanell Jackson was last updated on March 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.