1. Home
  2. Directory
  3. California
  4. Los Angeles
  5. Student In An Organized Health Care Education Training Program
  6. NPI Profile

CREDELL JACKSON JR.
NPI 1760968028
Student in an Organized Health Care Education/Training Program in Los Angeles, CA

Active since July 18, 2018
333 S BEAUDRY AVE, LOS ANGELES, CA 90017(213) 241-3305(213) 241-3305 Get Directions Write a Review

NPPES record last updated: July 18, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Credell Jackson Jr. NPPES

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

CREDELL JACKSON JR. (NPI 1760968028) is an individual student in an organized health care education/training program in Los Angeles, California and active in the NPI registry since July 2018.

NPPES Registry Identity

NPI1760968028
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameCREDELL JACKSON JR.
Location Address333 S BEAUDRY AVELos Angeles, CA 90017-1466
Mailing Address333 S Beaudry AveLos Angeles, CA 90017-1466 · (213) 241-3305 · Fax (213) 241-3305
Phone(213) 241-3305
Fax(213) 241-3305
Sole ProprietorNo
Enumeration DateJuly 18, 2018
✔ NPI 1760968028 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
333 S BEAUDRY AVE, Los Angeles, CA 90017
Open in Google Maps ↗

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.

KATHY ESTRADA MONTES LCSW
Social Worker (Clinical)
333 S BEAUDRY AVE
LOS ANGELES, CA 90017
Los Angeles County (213) 241-3841
ERIKA SANCHEZ
Social Worker (Clinical)
333 S BEAUDRY AVE
LOS ANGELES, CA 90017
Los Angeles County (213) 241-3841
ARPI GUBERMAN
Speech-Language Pathologist
333 S BEAUDRY AVE
LOS ANGELES, CA 90017
Los Angeles County (909) 964-8966
ANA MORAN LCSW
Social Worker (Clinical)
333 S BEAUDRY AVE
LOS ANGELES, CA 90017
Los Angeles County (213) 241-3841
ANA VIRGINIA AGUILAR
Student in an Organized Health Care Education/Training Program
333 S BEAUDRY AVE
LOS ANGELES, CA 90017
Los Angeles County (213) 241-3841
DAWN MARIE BRANNON LCSW
Social Worker (Clinical)
333 S BEAUDRY AVE
LOS ANGELES, CA 90017
Los Angeles County (213) 241-3841
SUSANA RABENA BUSTAMANTE LCSW
Social Worker (Clinical)
333 S BEAUDRY AVE
LOS ANGELES, CA 90017
Los Angeles County (213) 241-3841
SANDRA NAYELI MONTELONGO-KHUONG
Social Worker (Clinical)
333 S BEAUDRY AVE
LOS ANGELES, CA 90017
Los Angeles County (818) 993-9311

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 Credell Jackson's NPI number?

The NPI number for Credell Jackson is 1760968028. It was assigned to this individual provider in the NPPES registry on July 18, 2018.

Where is Credell Jackson located?

Credell Jackson practices at 333 S Beaudry Ave, Los Angeles, CA 90017. The listed phone number is (213) 241-3305.

What is Credell Jackson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Credell Jackson was last updated on July 18, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.