Individual provider · Type 1 NPI
Robert Romulus Jackson I
Rehabilitation Practitioner · Sylmar, CA
NPI number
1164058657
Active
Practice location
11600 Eldridge Ave
Sylmar, CA 91342-6506
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | None listed |
| Rehabilitation Practitioner Primary | 225400000X | None listed |
Rehabilitation Practitioner: A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity.
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About NPI 1164058657
Robert Romulus Jackson I's National Provider Identifier is 1164058657, issued on Mar 17, 2020. The primary taxonomy on file is Rehabilitation Practitioner (225400000X), and the practice location is in Sylmar, CA. The record was last updated on Jun 10, 2025.