Trent Lamarr Jackson

Primary specialty

Private VehicleTaxonomy code 347C00000X

License

A1243646 Issued in CA

Practice address

22756 Haynes St
West Hills, CA 91307-3606

Phone

(818) 517-2364

NPI assigned

Nov 26, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1543190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543190400000",
    "number": "1497225197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22756 HAYNES ST",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913073606",
            "telephone_number": "818-517-2364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22756 HAYNES ST",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913073606",
            "telephone_number": "818-517-2364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TRENT",
        "middle_name": "LAMARR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-26",
        "last_updated": "2018-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "CA",
            "license": "A1243646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danny Issa, MD
• Vanessa Chiu Istoc, DPT
• Mehdi Izadi, D.O.
• J-J Qual-Zerv, Inc.
• Kayla Jacks
• Bruce Allen Jacobson, M.D.
• Heather Jacobson, PMHNP-BC
• Nazanin Jalalian, APRN, FNP-C.
• Aamer H Jamali, MD
• Sakina Aamer Jamali, OD

• Private Vehicle in West Hills, CA
• Providers in West Hills, CA by specialty
• Private Vehicle in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.