Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1538604673 Individual Practitioner Female Practitioner

Kellie Jackson

Social Worker • Pasadena, CA

Professional Overview & Biography Verified Profile Summary

Kellie Jackson is a registered healthcare professional specializing in Social Worker in Pasadena, CA. Practice services are available at 100 W WALNUT ST STE 375 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

100 W Walnut St Ste 375

Pasadena, CA 911240001

Telephone 6263957100
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Social Worker in Pasadena, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 15.8 Yrs
State Avg: 16.2 Yrs
Regional Practice Density
128 Specialists

Practicing in Pasadena, CA (10507 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-06-23
Social Worker Primary Specialty

NUCC Taxonomy Code: 104100000X

State License CA 112050

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

Counselor - Mental Health

NUCC Taxonomy Code: 101YM0800X

State License CA 112050

Definition to come...

Rehabilitation Practitioner

NUCC Taxonomy Code: 225400000X

A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Jennie Mathess , PsyD

Psychologist - Clinical

NPI 1003035304

Doctor of Psychology (Psy.D.)

Mark Winkler

Rehabilitation Practitioner

NPI 1003087677
Martha Gonzalez

Rehabilitation Practitioner

NPI 1003129974
Ruby Garcia , LPT

Licensed Psychiatric Technician

NPI 1003158932
Jennifer Beckwith

Marriage & Family Therapist

NPI 1003159229
Tarik Blair

Rehabilitation Practitioner

NPI 1003188582

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 23, 2023

Counselor (License #112050 in CA)

📍
Updated Practice Location September 22, 2021

Registered at 100 W WALNUT ST STE 375, PASADENA, CA 911240001 (Tel: 6263957100)

📍
Updated Business Mailing Address September 22, 2021

Registered at 100 W WALNUT ST STE 375, PASADENA, CA 911240001 (Tel: 6263957100)

NPI Profile Active December 28, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location December 28, 2016

Registered at 210 S DE LACEY AVE STE 110, PASADENA, CA 911052074 (Tel: 6263957100)

📍
Updated Business Mailing Address December 28, 2016

Registered at 210 S DE LACEY AVE STE 110, PASADENA, CA 911052074 (Tel: 6263957100)

👤
Provider Name / Credentials Updated December 28, 2016

Recorded as KELLIE JACKSON

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 28, 2016

Rehabilitation Practitioner

🟢
Initial NPI Registration & Enumeration December 28, 2016

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1538604673
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 28, 2016
Last Update: June 23, 2023
Sole Proprietor: No

Mailing Address

100 W Walnut St Ste 375

Pasadena, CA 911240001

Phone: 6263957100

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.