Individual ProviderRuth Cassandra Victor - JacksonMarriage & Family TherapistBehavioral Health & Social Service ProvidersPractice Address3850 Crenshaw Blvd, Los Angeles, CA 90008-1821(323) 751-3026PECOS EnrollmentBased on the most recent information from CMS, provider Ruth Cassandra Victor - Jackson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1811566763Provider TypeIndividualFull NameVictor - Jackson, Ruth CassandraGenderFemaleSole ProprietorYesEnumeration Date6/23/2021Last Updated7/20/2021Contact InformationPractice LocationPractice Address3850 Crenshaw Blvd, Los Angeles, CA 90008-1821Phone(323) 751-3026FaxUnlisted FaxMailing LocationMailing Address3850 Crenshaw Blvd, Los Angeles, CA 90008-1821Phone(323) 751-3026FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106H00000XPrimaryDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicenseAMFT103811CaliforniaCode171M00000XDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer