Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

ANDRE WAYNE JACKSON OTHER
NPI 1174452387
Durable Medical Equipment & Medical Supplies in Richmond, CA

Q: What is Andre Jackson's NPI number?

The NPI number for Andre Jackson is 1174452387. It was assigned to this individual provider in the NPPES registry on May 14, 2026.

Q: What is Andre Jackson's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

Q: When was this NPI record last updated?

The NPPES record for Andre Jackson was last updated on May 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since May 14, 2026

2930 HILLTOP MALL RD STE B, RICHMOND, CA 94806(510) 222-1075(866) 665-8815 Get Directions Write a Review

NPPES record added: May 14, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Andre Wayne Jackson Other NPPES

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

ANDRE WAYNE JACKSON OTHER (NPI 1174452387) is an individual durable medical equipment & medical supplies provider in Richmond, California, licensed in California (101135) and active in the NPI registry since May 2026.

NPPES Registry Identity

NPI1174452387

Entity TypeIndividualMale

Primary Taxonomy332B00000X

Provider Legal NameANDRE WAYNE JACKSONCredential: OTHER

Location Address2930 HILLTOP MALL RD STE BRichmond, CA 94806-2197

Mailing Address2930 Hilltop Mall Rd Ste BRichmond, CA 94806-2197 · (510) 222-1075 · Fax (866) 665-8815

Phone(510) 222-1075

Fax(866) 665-8815

Sole ProprietorYes

Enumeration DateMay 14, 2026

NPPES CertifiedMay 14, 2026

✔ NPI 1174452387 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers

Taxonomy Code332B00000X

License✔ Licensed in CA · 101135

Definition

A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

2930 HILLTOP MALL RD STE B, Richmond, CA 94806

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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 Andre Jackson's NPI number?

The NPI number for Andre Jackson is 1174452387. It was assigned to this individual provider in the NPPES registry on May 14, 2026.

Where is Andre Jackson located?

Andre Jackson practices at 2930 Hilltop Mall Rd Ste B, Richmond, CA 94806. The listed phone number is (510) 222-1075.

What is Andre Jackson's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

When was this NPI record last updated?

The NPPES record for Andre Jackson was last updated on May 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.