Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Christian Deanthony Jackson, CTRS

Individual provider Recreation Therapist · NPI 1902492754

Christian Deanthony Jackson, CTRS is a Recreation Therapist in Long Beach, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2020
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Practice location Address checks out

330 Golden Shr Ste 250
Long Beach, CA 90802-4270
Phone: (562) 247-0713
Fax: (800) 985-5002
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Recreation Therapist (primary) Taxonomy 225800000X · Licence 83338 (CA)

Record details

NPI number1902492754
Entity typeIndividual (Type 1)
GenderMale
Credentials CTRS
Sole proprietorYes
NPI enumeratedDecember 16, 2020
Last updated in NPPESDecember 16, 2020
Certification dateDecember 16, 2020

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