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

Active since October 02, 2018PECOS Enrolled
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: July 19, 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
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

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Chanell Jackson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

Radiology (Diagnostic Radiology)
3630 E IMPERIAL HWY
LYNWOOD, CA 90262
Anesthesiology
3630 E IMPERIAL HWY
LYNWOOD, CA 90262
Anesthesiology
3630 E IMPERIAL HWY
LYNWOOD, CA 90262
Obstetrics & Gynecology
3630 E IMPERIAL HWY
LYNWOOD, CA 90262
Internal Medicine
3630 E IMPERIAL HWY
LYNWOOD, CA 90262
Anesthesiology
3630 E IMPERIAL HWY
LYNWOOD, CA 90262
Anesthesiology
3630 E IMPERIAL HWY
LYNWOOD, CA 90262
Anesthesiology
3630 E IMPERIAL HWY
LYNWOOD, CA 90262

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 enrollment system.

What insurance does Chanell Jackson accept?

Health plans from Providence Health Plan list Chanell Jackson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Chanell Jackson was last updated on March 23, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.