Individual provider · Type 1 NPI

Philip Jackson

Student in an Organized Health Care Education/Training Program · Los Angeles, CA

NPI number 1003597071 Active

Practice location

1902 Marengo St
Los Angeles, CA 90033-1312

Call (323) 276-6470 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed
Addiction (Substance Use Disorder) Counselor 101YA0400XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1003597071

Philip Jackson's National Provider Identifier is 1003597071, issued on Jul 31, 2023. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Los Angeles, CA. The record was last updated on Aug 24, 2026.