Active NPI
Tenika Louise Jackson, PSY.D.
- Clinical Psychologist
- Los Angeles, CA
National Provider Identifier
1114052818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY22468
- Practice address
- 8220 S San Pedro St
Los Angeles, CA 90003-3030 - Phone
- (323) 565-2300
- NPI assigned
- Feb 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY22468 | CA | Primary |
Addresses
Primary practice location
8220 S San Pedro St
Los Angeles, CA 90003-3030
Mailing address
3651 S Labrea Ave
Suite 699
Los Angeles, CA 90016-5300
Phone (213) 944-2200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY22468 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440028800000",
"number": "1114052818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3651 S LABREA AVE",
"address_2": "SUITE 699",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900165300",
"telephone_number": "213-944-2200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8220 S SAN PEDRO ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900033030",
"telephone_number": "323-565-2300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "TENIKA",
"middle_name": "LOUISE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-22",
"last_updated": "2015-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY22468",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.