Destanie Jackson, is a
Social Worker - Clinical based in Long Beach, California. Destanie Jackson is licensed to practice in California (license number 109019) and her current practice location is
3545 Long Beach Blvd, Long Beach, California. She can be reached at her office (for appointments etc.) via phone at
(562) 490-7600.
NPI number for Destanie Jackson is 1184320301 and her current mailing address is 3545 Long Beach Blvd, Long Beach, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1184320301.
Healthcare Provider's Profile
Full Name | Destanie Jackson |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 3545 Long Beach Blvd, Long Beach, California |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1184320301
- Provider Enumeration Date: 01/31/2023
- Last Update Date: 06/21/2023
Medical Identifiers
Medical identifiers for Destanie Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1184320301 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | 109019 (California) | Secondary |
1041C0700X | Social Worker - Clinical | 109019 (California) | 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. Destanie 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 |
Destanie Jackson, 3545 Long Beach Blvd, Long Beach, CA 90807-3941 Ph: (562) 490-7600 | Destanie Jackson, 3545 Long Beach Blvd, Long Beach, CA 90807-3941 Ph: (562) 490-7600 |
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