Anita Irene Jackson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

94587 Issued in CA

Practice address

2311 Loveridge Rd
Pittsburg, CA 94565-5117

Phone

(925) 431-2647

NPI assigned

Sep 6, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Anita Irene Jackson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Contra Costa County

  • Adult Mental Health Clinic/Center
  • Concord, CA
  • NPI 1023188489
  NPD
• Contra Costa County

  • Adult Mental Health Clinic/Center
  • San Pablo, CA
  • NPI 1376620336
  NPD
• Contra Costa County

  • General Acute Care Hospital
  • Martinez, CA
  • NPI 1386719086
  NPD

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588636800000",
    "number": "1366637993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 LOVERIDGE RD",
            "city": "PITTSBURG",
            "state": "CA",
            "postal_code": "945655117",
            "telephone_number": "925-431-2647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 LOVERIDGE RD",
            "city": "PITTSBURG",
            "state": "CA",
            "postal_code": "945655117",
            "telephone_number": "925-431-2647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ANITA",
        "middle_name": "IRENE",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-06",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "94587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANITA",
            "last_name": "JACKSON",
            "middle_name": "IRENE",
            "prefix": "MS.",
            "credential": "STUDENT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dameian Hunter
• Filma D Inaldo
• International Ally Federation
• Lauren Olivia Iroko, OTR/L
• Precious Mary Ita
• Brian Jackson Sr.
• Jaclyn Nicole Jackson, MA, PPS
• Tina Lorraine Jackson, CNA, HHA
• Siamack Jafari, DMD
• Sara Yakoob Jaka, MD

• Clinical Social Worker in Pittsburg, CA
• Providers in Pittsburg, 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 May 5, 2020; 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.