CHRISTIAN DEANTHONY JACKSON CTRS NPI 1902492754

NPI Information

NPI: 1902492754
Provider Name: CHRISTIAN DEANTHONY JACKSON, CTRS
Classification: Recreation Therapist - 225800000X
Entity Type: Individual
Address:
330 GOLDEN SHR STE 250
LONG BEACH, CA
ZIP 90802
Phone: (562) 247-0713
Get Directions

Christian Deanthony Jackson, CTRS is a recreation therapist in Long Beach, CA. The provider is a recreation therapist uses recreational activities for intervention in some physical, social or emotional behavior to bring about a desired change in that behavior and promote the growth and development of the patient. Christian Deanthony Jackson, CTRS NPI is 1902492754. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

330 GOLDEN SHR STE 250
LONG BEACH, CA
ZIP 90802-270
Phone: (562) 247-0713
Fax: (800) 985-5002

The enumeration date for this NPI number is 12/16/2020 and was last updated on 12/16/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	225800000X	Recreation Therapist		83338	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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