Shannon Jackson, RN

Primary specialty

Continuing Education/Staff Development Registered NurseTaxonomy code 163WC1600X

License

482450 Issued in CA

Practice address

618 W School St
Compton, CA 90220-1923

Phone

(310) 933-8253

Fax

(562) 600-7803

NPI assigned

Mar 29, 2022

Last updated

Jul 20, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 7

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• CNS Services, Inc

  dba Living Your Life Without Limits

  • Continuing Education/Staff Development Registered Nurse
  • Compton, CA
  • NPI 1639859002

  Mental Health

  NPD Authorized official
• Grandcare San Diego, LLC

  • Home Health Agency
  • San Diego, CA
  • NPI 1811395353
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1053051292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 W SCHOOL ST",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902201923",
            "telephone_number": "562-338-6087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 W SCHOOL ST",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902201923",
            "telephone_number": "310-933-8253",
            "fax_number": "562-600-7803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SHANNON",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-29",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "482450",
            "primary": false
        },
        {
            "code": "163WC1600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Continuing Education/Staff Development",
            "state": "CA",
            "license": "482450",
            "primary": true
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "CA",
            "license": "482450",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": "482450",
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "CA",
            "license": "482450",
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "CA",
            "license": "482450",
            "primary": false
        },
        {
            "code": "405300000X",
            "taxonomy_group": "",
            "desc": "Prevention Professional",
            "state": "CA",
            "license": "482450",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.livingyourlifewithoutlimits.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "618 W School St",
            "city": "Compton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902201923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nimat Islam
• Ronnie Islam
• Zakiyyah Iman Islam
• Elliana Ixta Madera
• Dwaine Jackson
• Victoria Maria Jacquez
• Margarita Jaime
• Mohsen N/a Jamei, MD
• James S. Byas, Jr., D.D.S. M.S. a Professional Corporation
• Alice Elizabeth James, R.N

• Continuing Education/Staff Development Registered Nurse in Compton, CA
• Providers in Compton, CA by specialty
• Continuing Education/Staff Development Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.