SASHA JACKSON, LLC (NPI# 1083220453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083220453 |
| Entity Type | Organization |
| Organization Name | SASHA JACKSON, LLC |
| Practice Address |
480 Ridge Creek Ln Patterson CA 95363-8776 |
| Mailing Address |
Po Box 1574 Patterson CA 95363-1574 |
| Practice Telephone | 2092420601 |
| Mailing Telephone | 2092420601 |
| Enumeration Date | 2020-09-21 |
| Last Update Date | 2020-09-21 |
| Authorized Official Name | SASHA JA-NAE JACKSON (OWNER) |
| Authorized Official Telephone | 2092420601 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Sasha Jackson, LLC | Former Legal Business Name - Organization |
| Street Address |
480 RIDGE CREEK LN |
| City | PATTERSON |
| State | CA |
| Zip Code | 95363-8776 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871090472 | Quadmed Medical Clinics of California, Inc. | Clinic/Center | 2065 Keystone Pacific Parkway, Patterson, CA 95363 | 2018-04-10 |
| 1295287613 | Chandni Mukesh Patel | Registered Nurse | 200 C Patterson, Patterson, CA 95363 | 2016-11-02 |
| 1700251279 | Carousel Onia | Registered Nurse | 1372 Samantha Creek Drive, Patterson, CA 95363 | 2015-12-09 |
| 1740534726 | Wal-mart Stores Inc | Technician/Technologist | 1030 Sperry Ave, Patterson, CA 95363 | 2012-10-30 |
| 1770725483 | Thomas Earl Klein | Dentist | 101 S El Circulo Ave, Patterson, CA 95363 | 2009-03-26 |
| 1740450808 | Gary Eric F Sanchez | Dentist | 1040 W. Las Palmas Ave., Suite C, Patterson, CA 95363 | 2008-03-05 |
| 1538381967 | Patterson Joint Unified Sd | Local Education Agency (LEA) | 510 Keystone Blvd, Patterson, CA 95363 | 2007-05-03 |
| 1538389234 | Modesto Advanced Diagnostic Imaging Medical Center | Radiology | 1108 Ward Avenue, Building A, Suite 1, Patterson, CA 95363 | 2007-04-26 |
| 1902849177 | Longs Drug Stores California LLC | Durable Medical Equipment & Medical Supplies | 1080 Sperry Ave, Patterson, CA 95363 | 2006-06-14 |
| 1982126397 | Neha Garg | Internal Medicine | 200 C St, Patterson, CA 95363 | 2017-07-07 |
| Find all providers in zip 95363 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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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.