Active NPI
Marilyn Jackson, LAC
- Acupuncturist
- Los Angeles, CA
National Provider Identifier
1386143840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 17746
- Practice address
- 2990 S Sepulveda Blvd Ste 205
Los Angeles, CA 90064-3973 - Phone
- (818) 434-8709
- NPI assigned
- Feb 9, 2018
- 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 |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 17746 | CA | Primary |
Addresses
Primary practice location
2990 S Sepulveda Blvd Ste 205
Los Angeles, CA 90064-3973
Mailing address
2990 S Sepulveda Blvd Ste 205
Los Angeles, CA 90064-3973
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)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marilyn Jackson LLC | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Health Service Clinic/Center
- Ridgefield, CT
- NPI 1235881814
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565136000000",
"number": "1386143840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2990 S SEPULVEDA BLVD STE 205",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900643973"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2990 S SEPULVEDA BLVD STE 205",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900643973",
"telephone_number": "818-434-8709"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "MARILYN",
"name_prefix": "Mrs.",
"credential": "LAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-02-09",
"last_updated": "2019-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "17746",
"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 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.