JACKSON WALL APCC, AMFT
NPI 1518577790
Counselor - Mental Health in Santa Monica, CA
About Jackson Wall Apcc, Amft NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACKSON WALL APCC, AMFT (NPI 1518577790) is an individual mental health provider in Santa Monica, California, licensed in California (AMFT120524) and active in the NPI registry since August 2020. He has opted out of Medicare through January 1, 2028.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Jackson Wall Apcc, Amft has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2024 through January 1, 2028.
Other Providers at the Same Location NPPES 5
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SANTA MONICA, CA 90404
SANTA MONICA, CA 90404
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 Jackson Wall's NPI number?
The NPI number for Jackson Wall is 1518577790. It was assigned to this individual provider in the NPPES registry on August 3, 2020.
Where is Jackson Wall located?
Jackson Wall practices at 1450 20th St, Santa Monica, CA 90404. The listed phone number is (310) 309-6001.
What is Jackson Wall's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Jackson Wall enrolled in Medicare?
No. Jackson Wall has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.
When was this NPI record last updated?
The NPPES record for Jackson Wall was last updated on August 13, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
