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MR. BRANDON JACKSON RECOVERY PRACTIONER
NPI 1457994634
Rehabilitation Practitioner in Los Angeles, CA

Active since October 21, 2019
1873 W 54TH ST, LOS ANGELES, CA 90062(562) 794-7892(310) 349-3660 Get Directions Write a Review

NPPES record last updated: October 21, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Brandon Jackson Recovery Practioner NPPES

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

MR. BRANDON JACKSON RECOVERY PRACTIONER (NPI 1457994634) is an individual rehabilitation practitioner in Los Angeles, California and active in the NPI registry since October 2019.

NPPES Registry Identity

NPI1457994634
Entity TypeIndividualMale
Primary Taxonomy225400000X
Provider Legal NameMR. BRANDON JACKSONCredential: RECOVERY PRACTIONER
Location Address1873 W 54TH STLos Angeles, CA 90062-2604
Mailing Address1873 W 54th StLos Angeles, CA 90062-2604 · (562) 794-7892 · Fax (310) 349-3660
Phone(562) 794-7892
Fax(310) 349-3660
Sole ProprietorNo
Enumeration DateOctober 21, 2019
✔ NPI 1457994634 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyRehabilitation PractitionerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225400000X
Definition
A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity.
Also ListedPeer SpecialistTaxonomy 175T00000X
1873 W 54TH ST, Los Angeles, CA 90062
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Other Identifiers 1

Medicaid1699246272CA

Other Providers at the Same Location NPPES 4

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

MR. HENRY N HOBDY PEER SPECIALIST
Rehabilitation Practitioner
1873 W 54TH ST
LOS ANGELES, CA 90062
Los Angeles County (323) 331-5678
MR. RODERICK VINCENT TODD RECOVERY PRACTIONER
Rehabilitation Practitioner
1873 W 54TH ST
LOS ANGELES, CA 90062
Los Angeles County (424) 440-5660
MRS. PAMELA HOSKINS CPSS
Rehabilitation Practitioner
1873 W 54TH ST
LOS ANGELES, CA 90062
Los Angeles County (562) 400-2912
CREATE REALISTIC CHANGE INC
Clinic/Center (Rehabilitation)
1873 W 54TH ST
LOS ANGELES, CA 90062
Los Angeles County (424) 222-1795

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 Brandon Jackson's NPI number?

The NPI number for Brandon Jackson is 1457994634. It was assigned to this individual provider in the NPPES registry on October 21, 2019.

Where is Brandon Jackson located?

Brandon Jackson practices at 1873 W 54th St, Los Angeles, CA 90062. The listed phone number is (562) 794-7892.

What is Brandon Jackson's specialty?

The primary specialty registered for this NPI is Rehabilitation Practitioner with taxonomy code 225400000X.

When was this NPI record last updated?

The NPPES record for Brandon Jackson was last updated on October 21, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.