JEANETTE JACKSON (NPI# 1396175626) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396175626 |
| Entity Type | Individual |
| Full Name | JEANETTE JACKSON |
| Practice Address |
4705 N Sonora Ave Fresno CA 93722-3966 |
| Practice Telephone | 5592767558 |
| Practice Fax Number | 5592767568 |
| Mailing Telephone | 5592767558 |
| Mailing Fax Number | 5592767568 |
| Enumeration Date | 2013-11-22 |
| Last Update Date | 2013-11-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063058956 | Jeanette Jackson | Counselor | 770 Woodlane Rd, Westampton, NJ 08060-3804 | 2019-11-26 |
| 1184856239 | Jeanette Jackson | Counselor | 1300 Avenue P, Brooklyn, NY 11229-1106 | 2009-08-21 |
| 1407019797 | Jeanette Jackson | Social Worker | 12422 Nw G T Revell Rd, Bristol, FL 32321-3007 | 2008-07-07 |
| 1184719023 | Jeanette Helen Jackson | Internal Medicine | 75 Avenue B, Richwood, WV 26261-1236 | 2006-10-04 |
| 1710935820 | Jeanette Jackson | Nurse Anesthetist, Certified Registered | 7703 Floyd Curl Dr, San Antonio, TX 78229-3901 | 2006-05-04 |
| Street Address |
4705 N SONORA AVE |
| City | FRESNO |
| State | CA |
| Zip Code | 93722-3966 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629255609 | Mark Blanton | Counselor | 4705 N Sonora Ave, Fresno, CA 93722-3966 | 2008-01-22 |
| 1538609961 | Healthy Life Home Services, Inc | Home Health | 4705 N Sonora Ave, Suite 106, Fresno, CA 93722-3966 | 2017-03-04 |
| 1922438480 | Tafailagi Yandall | Counselor | 4705 N Sonora Ave, Fresno, CA 93722-3966 | 2013-11-20 |
| 1851640247 | Jeremiah Brubaker | Counselor | 4705 N Sonora Ave, Suite 113, Fresno, CA 93722-3966 | 2012-08-31 |
| 1851679260 | Minerva Minnie Mijangos | Counselor | 4705 N Sonora Ave, Suite 113, Fresno, CA 93722-3966 | 2011-08-02 |
| 1841580578 | Yolanda Theresa Bowen | Contractor | 4705 N Sonora Ave, Suite 113, Fresno, CA 93722-3966 | 2011-04-14 |
| 1831488964 | Robert Lee Bohanna | Counselor | 4705 N Sonora Ave, Suite 113, Fresno, CA 93722-3966 | 2011-03-29 |
| 1861796062 | Maria Angelica Galvan | Interpreter | 4705 N Sonora Ave, Suite 113, Fresno, CA 93722-3966 | 2011-01-03 |
| 1508181413 | Carina Gonzolez Espitia | Community Health Worker | 4705 N Sonora Ave, Suite 113, Fresno, CA 93722-3966 | 2010-04-02 |
| 1467782102 | Delta Care Inc | Community/Behavioral Health | 4705 N Sonora Ave, Suite 113, Fresno, CA 93722-3966 | 2009-12-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649871419 | Jay Galarza | Behavior Technician | 5490 N. Salinas Ave., Apt. L133, Fresno, CA 93722 | 2020-11-06 |
| 1609414291 | Edgar Torres Becerra | Counselor | 3793 N Polk, Fresno, CA 93722 | 2019-12-15 |
| 1780220822 | United Health Centers of The San Joaquin Valley | Clinic/Center | 6810 N Milburn Ave, Fresno, CA 93722 | 2019-11-25 |
| 1710545322 | Vijay S Dalvi | Pharmacist | 6055 N Brawley Ave, Apt 235, Fresno, CA 93722 | 2019-05-30 |
| 1205322047 | A Plus Home Health, Inc. | Home Health | 3455 W. Shaw Ave. # 107, Fresno (and Vicinity), CA 93722 | 2018-07-05 |
| 1891282018 | Danielle Morales | Case Manager/Care Coordinator | 2880 N Valentine Ave, Fresno, CA 93722 | 2018-04-13 |
| 1669981791 | Gabriela Miranda | Case Manager/Care Coordinator | 5467 N Carlsbad Ave, Fresno, CA 93722 | 2017-09-20 |
| 1811415508 | Vanessa Leite | Psychologist | 6157 N Figarden Dr #104, Fresno, CA 93722 | 2017-09-01 |
| 1821473935 | Premium Urgent Care, Inc. | Clinic/Center | 6643 N. Milburn Ave, Suite 104, Fresno, CA 93722 | 2015-07-30 |
| 1497157820 | Ordust Dialysis LLC | Clinic/Center | 6655 N Milburn Ave, Fresno, CA 93722 | 2014-09-17 |
| Find all providers in zip 93722 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164022976 | Denise Renee Hands | Counselor | 4604 E Terrace Ave, Fresno, CA 93703-2079 | 2020-10-30 |
| 1649807694 | Debbie Jeneen Darden | Counselor | 891 W Kearney Blvd, Fresno, CA 93706-2514 | 2020-03-26 |
| 1205466802 | Elizabeth C Esqueda | Counselor | 804 S Parallel Ave, Fresno, CA 93721-2404 | 2020-01-22 |
| 1295378446 | Caussaundra Maria Dominguez | Counselor | 2772 S Martin Luther King, Fresno, CA 93706 | 2019-10-21 |
| 1881244945 | Aurelio Mendoza | Counselor | 1414 W. Kearney Blvd, Fresno, CA 93706 | 2019-09-19 |
| 1356994909 | Joaquin Sanchez | Counselor | Quest House 2731 W Olive Ave, Fresno, CA 93728 | 2019-07-23 |
| 1003374539 | Jasmine Elizabeth Flores | Counselor | 2772 S Martin Luther King Junior Blvd, Fresno, CA 93706 | 2019-03-04 |
| 1104397348 | Brian K Bradley | Counselor | 2212 N Winery Ave, Fresno, CA 93703-2896 | 2018-12-16 |
| 1063982049 | Bruno Sivongxay | Counselor | 2772 South Martin L King Jr Blvd, Fresno, CA 93706 | 2018-12-03 |
| 1831669951 | Ashlee Faith Vasquez | Counselor | 1900 N Gateway Blvd Ste 100, Fresno, CA 93727-1622 | 2018-12-01 |
| Find all providers in FRESNO | ||||
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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.