Individual
SHANNON JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
618 W SCHOOL ST, COMPTON, CA 90220-1923
(310) 933-8253
(562) 600-7803
Mailing address
618 W SCHOOL ST, COMPTON, CA 90220-1923
(562) 338-6087
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
482450
CA
163WC1600X
Continuing Education/Staff Development Registered Nurse
Primary
482450
CA
163WD0400X
Diabetes Educator Registered Nurse
482450
CA
171400000X
Health & Wellness Coach
482450
CA
171M00000X
Case Manager/Care Coordinator
482450
CA
174H00000X
Health Educator
482450
CA
405300000X
Prevention Professional
482450
CA
Other
Enumeration date
03/29/2022
Last updated
07/20/2023
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