Brandi Nicole Jackson, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

89088 Issued in CA

Practice address

5504 Monterey Hwy
San Jose, CA 95138-1529

Phone

(510) 674-5555

NPI assigned

Mar 25, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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

{
    "created_epoch": "1458864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1255793501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4470 W SUNSET BLVD STE 107",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276309",
            "telephone_number": "510-674-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5504 MONTEREY HWY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951381529",
            "telephone_number": "510-674-5555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4470 W Sunset Blvd Ste 107",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900276309",
            "country_code": "US",
            "telephone_number": "510-674-5555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9955 Black Mountain Rd",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921264514",
            "country_code": "US",
            "telephone_number": "510-674-5555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "BRANDI",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-25",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "89088",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "89088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jack Dubin DMD Inc
• Jack Siegel, M.D., Inc.
• Jack Tian Acupuncture
• Larica Fantasia Jacko
• Jackson LTC Pharmacy Inc.
• Courtney Jackson
• Cyreetta Jackson
• Gabrielle Raquel Jackson
• Jennifer N Jackson, MSW
• Jonathan Jackson

• Clinical Social Worker in San Jose, CA
• Providers in San Jose, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.