Active NPI
Raquell Jackson
- Case Manager/Care Coordinator
- Los Angeles, CA
National Provider Identifier
1164339412
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 1733 W 51St St
Los Angeles, CA 90062-2219 - Phone
- (323) 635-9126
- NPI assigned
- Aug 24, 2026
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
1733 W 51St St
Los Angeles, CA 90062-2219
Mailing address
1733 W 51St St
Los Angeles, CA 90062-2219
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1787529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787529600000",
"number": "1164339412",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1733 W 51ST ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900622219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1733 W 51ST ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900622219",
"telephone_number": "323-635-9126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "RAQUELL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-08-24",
"last_updated": "2026-08-24",
"certification_date": "2026-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"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 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.