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

Mr. Brandon Jackson, RECOVERYPRACTIONER

Individual provider Peer Specialist · NPI 1457994634

Mr. Brandon Jackson, RECOVERYPRACTIONER is a Peer Specialist in Los Angeles, California. Licensed in California. Registered with an NPI since 2019.

Licensed in
CA
In the registry since
2019
Specialties on file
2

Practice location Address checks out

1873 W 54th St
Los Angeles, CA 90062-2604
Phone: (562) 794-7892
Fax: (310) 349-3660
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Rehabilitation Practitioner (primary) Taxonomy 225400000X (CA)
Peer Specialist Taxonomy 175T00000X

Record details

NPI number1457994634
Entity typeIndividual (Type 1)
GenderMale
Credentials RECOVERYPRACTIONER
Sole proprietorNo
NPI enumeratedOctober 21, 2019
Last updated in NPPESOctober 21, 2019

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