| Kim Elaine Jackson, LICSW | |
|
4909 Davenport Ave, Oakland, CA 94619-2920 | |
| (206) 549-4668 | |
| (206) 568-7043 |
| Full Name | Kim Elaine Jackson |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 4909 Davenport Ave, Oakland, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184275166 | NPI | - | NPPES |
| 2229463 | Medicaid | DC | |
| 2229463 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LC50082406 (District Of Columbia) | Secondary |
| 1041C0700X | Social Worker - Clinical | LW61326871 (Washington) | Primary |
| Entity Name | Uplift Health Technologies Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770189243 PECOS PAC ID: 5092109918 Enrollment ID: O20220218000586 |
| Mailing Address | Practice Location Address |
|---|---|
| Kim Elaine Jackson, LICSW 1253 C St Se, Washington, DC 20003-2202 Ph: (206) 549-4668 | Kim Elaine Jackson, LICSW 4909 Davenport Ave, Oakland, CA 94619-2920 Ph: (206) 549-4668 |
Ms. Karen Lisa Thomas, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 747 52nd Street, Oakland, CA 94609 Phone: 510-701-8751 | |
Mr. Gilberto Madrid, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3867 Howe St, Oakland, CA 94611 Phone: 510-531-3894 | |
Patricia Ann Sweetwine, MSW, MPH Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 5709 Market St, Oakland, CA 94608 Phone: 510-652-3300 Fax: 510-652-7720 | |
Ms. Yvonne Diane Escarsega, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1411 E 31st St, Oakland, CA 94602 Phone: 510-437-4373 Fax: 510-437-5170 | |
Ms. Stacey Nicole Francis, M.S.W. Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 925 Brockhurst St, Oakland, CA 94608 Phone: 510-923-9600 | |
Mrs. Abby Ross Blum, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 5349 College Ave, Oakland, CA 94618 Phone: 510-206-9319 | |
Aretha Hampton, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 465 34th St, Oakland, CA 94609 Phone: 510-847-8847 |