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

Jackson Wall, APCC, AMFT

Individual provider Mental Health Counselor · NPI 1518577790

Jackson Wall, APCC, AMFT is a Mental Health Counselor in Santa Monica, California. Licensed in California. Registered with an NPI since 2020.

Licensed in
CA
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

1450 20th St
Santa Monica, CA 90404-2906
Phone: (310) 309-6001
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence AMFT120524 (CA)
Mental Health Counselor Taxonomy 101YM0800X · Licence APCC8154 (CA)

Record details

NPI number1518577790
Entity typeIndividual (Type 1)
GenderMale
Credentials APCC , AMFT
Sole proprietorNo
NPI enumeratedAugust 3, 2020
Last updated in NPPESAugust 13, 2020
Certification dateAugust 13, 2020

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