JUDITH ANN JACKSON (NPI# 1104100775) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104100775 |
| Entity Type | Individual |
| Full Name | JUDITH ANN JACKSON |
| Practice Address |
1400 Emeline Ave Santa Cruz CA 95060-1976 |
| Practice Telephone | 8314544971 |
| Enumeration Date | 2011-09-30 |
| Last Update Date | 2012-11-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | COUNTY OF SANTA CRUZ MEDI-CAL PROVIDER# | FHC70044F | 01 |
| CA | COUNTY OF SANTA CRUZ MEDICARE GROUP# | ZZZ91892Z | 01 |
| CA | COUNTY OF SANTA CRUZ MEDI-CAL PROVIDER# | FHC70042F | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114575016 | Judith Lynn Jackson | Technician | 2820 N Cherry St Apt C105, Spokane Valley, WA 99216-5009 | 2019-09-04 |
| 1356585343 | Judith A Jackson | Registered Nurse | 1622 E 24th St, Brooklyn, NY 11229-2402 | 2009-04-22 |
| 1497973911 | Judith Temple Jackson | Psychologist | 125 Coulter Ave, Floor 2, Ardmore, PA 19003-2410 | 2007-04-22 |
| 1932238128 | Judith Francine Jackson | Dental Assistant | 5135 Skyline Rd. S., Salem, OR 97306 | 2007-03-05 |
| 1952444721 | Judith Jackson | Family Medicine | 13856 N Dale Mabry Hwy, Tampa, FL 33618-2420 | 2007-02-14 |
| 1821055880 | Judith Jackson | Nurse Practitioner | 2450 Riverside Ave, Minneapolis, MN 55454-1395 | 2006-04-26 |
| Street Address |
1400 EMELINE AVE |
| City | SANTA CRUZ |
| State | CA |
| Zip Code | 95060-1976 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114925526 | William C Falzett Jr. | Psychologist | 1400 Emeline Ave, Santa Cruz, CA 95060-1976 | 2005-07-09 |
| 1013518125 | Magali Eunice Arriaga Ortiz | Nurse's Aide | 1400 Emeline Ave, Santa Cruz, CA 95060-1976 | 2020-11-04 |
| 1154920098 | Andromeda Marie Scheller | Nurse's Aide | 1400 Emeline Ave, Santa Cruz, CA 95060-1976 | 2020-10-21 |
| 1124665286 | Jeremy Lansing | Social Worker | 1400 Emeline Ave, Santa Cruz, CA 95060-1976 | 2019-12-06 |
| 1013564806 | Amanda Lynett Travers | Counselor | 1400 Emeline Ave, Santa Cruz, CA 95060-1976 | 2019-08-26 |
| 1144887928 | Nathan J Riera | Rehabilitation Counselor | 1400 Emeline Ave, Santa Cruz, CA 95060-1976 | 2019-05-28 |
| 1386201242 | Joseph Harris Price IIi | Counselor | 1400 Emeline Ave, Santa Cruz, CA 95060-1976 | 2019-05-24 |
| 1841759305 | Julie Delophine Keller-olivas | Registered Nurse | 1400 Emeline Ave, Santa Cruz, CA 95060-1976 | 2019-03-14 |
| 1962981282 | Robert Antonio Gomez | Public Health or Welfare | 1400 Emeline Ave, Santa Cruz, CA 95060-1976 | 2018-08-08 |
| 1154808368 | Diana Marcela Eaton | Nurse's Aide | 1400 Emeline Ave, Santa Cruz, CA 95060-1976 | 2018-07-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366940215 | Tiphanie Bowens | Counselor | 380 Encinal St., Suite 200, Santa Cruz, CA 95060 | 2018-01-25 |
| 1942714167 | Kyle Hardwick | Chiropractor | 203 River Street, Santa Cruz, CA 95060 | 2017-11-27 |
| 1972015741 | Nina Marie Francesconi | Acupuncturist | 110 Fern St Apt. C, Santa Cruz, CA 95060 | 2017-11-01 |
| 1679091870 | Laura Evelyn Rochelle | Counselor | 380 Encinal St., Suit 200, Santa Cruz, CA 95060 | 2017-09-07 |
| 1649797903 | Jessica Tarnoff | Counselor | 716 Ocean St., Santa Cruz, CA 95060 | 2017-08-28 |
| 1356862064 | Lakia Niema Queen | Counselor | 542 Ocean Street Suite K, Santa Cruz, CA 95060 | 2017-07-03 |
| 1023555992 | Allison Whitehead | Nurse Practitioner | 1080 Emeline Ave., County of Santa Cruz Health Services Agency, Santa Cruz, CA 95060 | 2017-01-30 |
| 1659827293 | Annabelle Drda | Marriage & Family Therapist | 303 Portero St, Santa Cruz, CA 95060 | 2016-09-01 |
| 1376999698 | Erin Liana Johnson | Counselor | 104 Walnut Avenue, Suite 208, Santa Cruz, CA 95060 | 2016-05-05 |
| 1659732097 | Daniel Ezekiel Contreras | Counselor | 1080 Emeline Building D, Santa Cruz, CA 95060 | 2016-03-13 |
| Find all providers in zip 95060 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770116311 | Minfu Liang | Counselor | 180 Dakota Ave Apt 54, Santa Cruz, CA 95060-6615 | 2020-02-21 |
| 1932746351 | Kimberly Frey | Counselor | 1530 Bulb Ave, Santa Cruz, CA 95062-3219 | 2019-12-04 |
| 1346806395 | Cynthia Diane Gray | Counselor | 127 Ladera Dr, Santa Cruz, CA 95060-5210 | 2019-05-15 |
| 1053870634 | Yoloxochitl Sadya Hunter | Counselor | 577 Soquel Ave, Santa Cruz, CA 95062-2309 | 2019-03-13 |
| 1295214708 | Jeanne Willis | Counselor | 157 Van Ness Ave Ste 6, Santa Cruz, CA 95060-4200 | 2018-08-07 |
| 1528554649 | Caitlin Mcavoy | Counselor | 303 Potrero St Ste 42-101, Santa Cruz, CA 95060-2779 | 2018-07-02 |
| 1366940215 | Tiphanie Bowens | Counselor | 380 Encinal St., Suite 200, Santa Cruz, CA 95060 | 2018-01-25 |
| 1023522646 | Paula Ann Sims | Counselor | 303 Potrero St Ste 43-103, Santa Cruz, CA 95060-2777 | 2017-11-17 |
| 1679091870 | Laura Evelyn Rochelle | Counselor | 380 Encinal St., Suit 200, Santa Cruz, CA 95060 | 2017-09-07 |
| 1306360664 | Thomas Lucking | Counselor | 1414 Soquel Ave, Santa Cruz, CA 95062-2110 | 2017-07-28 |
| Find all providers in SANTA CRUZ | ||||
| City | SANTA CRUZ |
| Zip Code | 95060 |
Please comment or provide details below to improve the information on JUDITH ANN JACKSON.
| 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.