DAVETTA JACKSON-YOUNG (NPI# 1023426228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1023426228 |
Entity Type | Individual |
Full Name | DAVETTA JACKSON-YOUNG |
Other Name | DAVETTA JACKSON-YOUNG |
Practice Address |
8863 Santa Maria Way Stockton CA 95210-1145 |
Mailing Address |
8863 Santa Maria Way Stockton CA 95210 |
Practice Telephone | 6787045213 |
Mailing Telephone | 6787045213 |
Enumeration Date | 2014-07-31 |
Last Update Date | 2014-07-31 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 106H00000X | Marriage & Family Therapist | 00320397 | CA | Behavioral Health & Social Service Providers |
N | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers |
Street Address |
8863 SANTA MARIA WAY |
City | STOCKTON |
State | CA |
Zip Code | 95210-1145 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063021970 | Leslie Jazmin Marin | Student in an Organized Health Care Education/Training Program | 7109 Danny Dr, Stockton, Stockton, CA 95210 | 2020-07-27 |
1043866692 | Alexis Thomasson | Behavior Technician | 7109 Danny Drive, Stockton, CA 95210 | 2019-08-09 |
1821651324 | Maria Guadalupe Toledo | Lactation Consultant, Non-RN | 7912 Hammer Lane, Stockton, CA 95210 | 2019-04-19 |
1508226440 | Active Life Adult Day Care, Inc. | Clinic/Center | 7209 Tam O'shanter Dr., Stockton, CA 95210 | 2016-03-04 |
1548631260 | Rachel Standley | Substance Abuse Rehabilitation Facility | 8017 El Cajon St, Stockton, CA 95210 | 2015-10-08 |
1225435308 | Active Life Medical Produtcs Inc | Durable Medical Equipment & Medical Supplies | 611 W Grider Way, Stockton, CA 95210 | 2014-12-04 |
1942633318 | Kimberly Ruiz Dizon | Physician Assistant | 1530 E Hammer Ln, Stockton, CA 95210 | 2013-08-20 |
1285920983 | Supplemental Health Care | Preferred Provider Organization | 8425 Kiltie Wy, Stockton, CA 95210 | 2011-06-22 |
1770807901 | Stockton Medical Weight Loss Center Inc | Internal Medicine | 1801 E. March Lane, Suite 400d, Stockton, CA 95210 | 2010-03-17 |
1699911412 | Pratap Krishna Anne | Pharmacist | 1801 E.march Ln, Suite:b280, Bjrx, Stockton, CA 95210 | 2008-12-29 |
Find all providers in zip 95210 |
Taxonomy Code | 106H00000X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Marriage & Family Therapist |
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528532991 | Stephen Elias | Marriage & Family Therapist | 1414 N California St Ste 2, Stockton, CA 95202-1515 | 2019-01-18 |
1235614116 | Michelle Ann Horn | Marriage & Family Therapist | 3666 Mission Rd, Stockton, CA 95204 | 2018-09-26 |
1083117188 | Ryan Rix | Marriage & Family Therapist | 510 E Magnolia St Ste 100, Stockton, CA 95202-1850 | 2018-03-14 |
1821538273 | Lisa Marie Richardson | Marriage & Family Therapist | 2852 Elmwood Ave Apt 9, Stockton, CA 95204-3949 | 2017-03-05 |
1750837985 | Alexsandra Trejo | Marriage & Family Therapist | 6707 Embarcadero Drive, Stockton, CA 95219 | 2016-08-28 |
1992179352 | Frank Garcia | Marriage & Family Therapist | 5302 Harvest Gold Dr, Stockton, CA 95219-2432 | 2015-11-23 |
1144696840 | Wilhelmina Marie Parsons | Marriage & Family Therapist | 1212 California Street, Stockton, CA 95202 | 2015-08-17 |
1962887554 | Gurmeet Singh | Marriage & Family Therapist | 4635 Georgetown Pl Ste A, Stockton, CA 95207-6203 | 2015-07-23 |
1598148165 | Roberta Ann Novo | Marriage & Family Therapist | 4750 Quail Lakes Drive, Suite C-2, Stockton, CA 95207 | 2015-07-01 |
1316328792 | San Juana Melgoza | Marriage & Family Therapist | 306 E Main St Ste 300, Stockton, CA 95202-2908 | 2015-06-11 |
Find all providers in STOCKTON |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.