Jackson, Samantha Nailah Mitchelle

Jackson, Samantha Nailah Mitchelle is an individual health care provider with primary practice located at 649 E Albertoni St Ste 100 , Carson CA 90746-1538. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Jackson, Samantha Nailah Mitchelle can be contacted via phone (310) 436-9300.

Contact Information

Primary practice address
649 E Albertoni St Ste 100 Carson CA 90746-1538
Phone: (310) 436-9300
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 102031 California
Behavioral Health & Social Service Providers / Social Worker 104100000X ACSW102031 California
Behavioral Health & Social Service Providers / Mental Health 101YM0800X ACSW102031 California

Profile Details

NPI number 1720653603
LBN Legal business name Jackson, Samantha Nailah Mitchelle
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2021
Last updated Aug 10th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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