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DESTANIE JACKSON
NPI 1184320301
Social Worker - Clinical in Long Beach, CA

Active since January 31, 2023
3545 LONG BEACH BLVD, LONG BEACH, CA 90807(562) 490-7600 Get Directions Write a Review

NPPES record last updated: June 21, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 21, 2023, Jan 31, 2023 (2 updates tracked since 2023).

About Destanie Jackson NPPES

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

DESTANIE JACKSON (NPI 1184320301) is an individual clinical provider in Long Beach, California, licensed in California (109019) and active in the NPI registry since January 2023.

NPPES Registry Identity

NPI1184320301
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameDESTANIE JACKSON
Location Address3545 LONG BEACH BLVDLong Beach, CA 90807-3941
Mailing Address3545 Long Beach BlvdLong Beach, CA 90807-3941 · (562) 490-7600
Phone(562) 490-7600
Sole ProprietorNo
Enumeration DateJanuary 31, 2023
Last NPPES UpdateJune 21, 20232 updates tracked since enumeration
NPPES CertifiedJune 21, 2023
✔ NPI 1184320301 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 · 109019
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 109019 (CA)
3545 LONG BEACH BLVD, Long Beach, CA 90807
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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.

KATIE MELODY SHUBIN PA-C
Physician Assistant (Medical)
3545 LONG BEACH BLVD, SUITE 105
LONG BEACH, CA 90807
Los Angeles County (562) 595-0060
HOME CARE NETWORK, INC.
Home Health
3545 LONG BEACH BLVD, SUITE 310
LONG BEACH, CA 90807
Los Angeles County (562) 290-8181
PAIN MANAGEMENT MEDICAL CENTER
Pain Medicine (Pain Medicine)
3545 LONG BEACH BLVD, SUITE 105
LONG BEACH, CA 90807
Los Angeles County (562) 595-0060
CINTHYA BELTRAN SOTO
Marriage & Family Therapist
3545 LONG BEACH BLVD
LONG BEACH, CA 90807
Los Angeles County (562) 490-7600
POOJA PATEL SHAH
Marriage & Family Therapist
3545 LONG BEACH BLVD
LONG BEACH, CA 90807
Los Angeles County (562) 490-7600
VI LE
Marriage & Family Therapist
3545 LONG BEACH BLVD
LONG BEACH, CA 90807
Los Angeles County (562) 490-7600
TATIANA SHELLMAN
Case Manager/Care Coordinator
3545 LONG BEACH BLVD
LONG BEACH, CA 90807
Los Angeles County (562) 490-7600
AMAL AL ALAMI
Marriage & Family Therapist
3545 LONG BEACH BLVD
LONG BEACH, CA 90807
Los Angeles County (562) 498-5500

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 Destanie Jackson's NPI number?

The NPI number for Destanie Jackson is 1184320301. It was assigned to this individual provider in the NPPES registry on January 31, 2023.

Where is Destanie Jackson located?

Destanie Jackson practices at 3545 Long Beach Blvd, Long Beach, CA 90807. The listed phone number is (562) 490-7600.

What is Destanie Jackson's specialty?

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

When was this NPI record last updated?

The NPPES record for Destanie Jackson was last updated on June 21, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.