Keith Lopez Jackson, is a
Community Health Worker based in Los Angeles, California. Keith Lopez Jackson is licensed to practice in * (Not Available) (license number ) and his current practice location is
3850 Crenshaw Blvd, Los Angeles, California. He can be reached at his office (for appointments etc.) via phone at
(323) 751-3026.
NPI number for Keith Lopez Jackson is 1043049356 and his current mailing address is 3850 Crenshaw Blvd, Los Angeles, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1043049356.
Healthcare Provider's Profile
| Full Name | Keith Lopez Jackson |
|---|
| Gender | Male |
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| Speciality | Community Health Worker |
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| Location | 3850 Crenshaw Blvd, Los Angeles, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1043049356
- Provider Enumeration Date: 07/26/2024
- Last Update Date: 08/21/2024
Medical Identifiers
Medical identifiers for Keith Lopez Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1043049356 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Secondary |
| 172V00000X | Community Health Worker | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Keith Lopez Jackson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Keith Lopez Jackson,
3850 Crenshaw Blvd,
Los Angeles, CA 90008-1821
Ph: (323) 751-3026 | Keith Lopez Jackson,
3850 Crenshaw Blvd,
Los Angeles, CA 90008-1821
Ph: (323) 751-3026 |
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