MRS. SHANNON MARIE JACKSON (NPI# 1558742395) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558742395 |
| Entity Type | Individual |
| Full Name | MRS. SHANNON MARIE JACKSON |
| Practice Address |
4990 Williams Ave La Mesa CA 91942-7409 |
| Practice Telephone | 6196684265 |
| Practice Fax Number | 6196684264 |
| Mailing Telephone | 6196684265 |
| Mailing Fax Number | 6196684264 |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2015-06-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | LPCC658 | CA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BBS | LPCC658 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235761149 | Shannon M Jackson | In Home Supportive Care | 4028 Vira Rd, Stow, OH 44224-3637 | 2020-02-08 |
| 1124526280 | Shannon Jackson | Nurse Practitioner | 850 Independence Ave, Akron, OH 44310-2541 | 2018-01-24 |
| 1588182463 | Shannon Daneigh Jackson | Technician | 4660 Martin Luther King Jr Ave Sw Apt B406, Washington, DC 20032-4978 | 2017-08-31 |
| 1851842843 | Shannon Regina Jackson | Nurse Practitioner | 294 Cypress Lakes Dr., Slidell, LA 70458 | 2016-10-14 |
| 1598027393 | Shannon Jackson | Behavioral Analyst | 2325 Nw 115th St, Oklahoma City, OK 73120-7309 | 2012-06-08 |
| 1417281064 | Shannon Jackson | Psychologist | 150 North Main St, Echn Health Services, Manchester, CT 06040-4188 | 2009-09-30 |
| 1235766601 | Shannon Laura Jackson | Registered Nurse | 2301 Erwin Rd, Durham, NC 27705-4699 | 2020-03-25 |
| 1407411366 | Shannon Jackson | Physical Therapy Assistant | 730 Thimble Shoals Blvd Ste 130, Newport News, VA 23606-4562 | 2019-05-07 |
| 1811323645 | Shannon Denise Jackson | Nurse Practitioner | 2800 Dallas Pkwy, Suite 150, Plano, TX 75093-5993 | 2013-09-25 |
| 1033429832 | Shannon Byrd Jackson | Dietitian, Registered | 1705 Tarboro St Sw, Wilson, NC 27893-3428 | 2010-10-14 |
| Street Address |
4990 WILLIAMS AVE |
| City | LA MESA |
| State | CA |
| Zip Code | 91942-7409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891833125 | Vista Hill Foundation | Community/Behavioral Health | 4990 Williams Ave, La Mesa, CA 91942-7409 | 2007-02-01 |
| 1851935019 | Kimberly Brown | Counselor | 4990 Williams Ave, La Mesa, CA 91942-7409 | 2019-10-31 |
| 1366093429 | Ashley Daye Anderson | Counselor | 4990 Williams Ave, La Mesa, CA 91942-7409 | 2019-09-20 |
| 1164084257 | Lena Pargo | Counselor | 4990 Williams Ave, La Mesa, CA 91942-7409 | 2019-06-28 |
| 1114583010 | Laurie Alcaraz | Counselor | 4990 Williams Ave, La Mesa, CA 91942-7409 | 2019-05-15 |
| 1235604505 | Angelena Swift | Counselor | 4990 Williams Ave, La Mesa, CA 91942-7409 | 2018-10-12 |
| 1588139794 | Takeenya Shontelle Hill | Counselor | 4990 Williams Ave, La Mesa, CA 91942-7409 | 2018-10-04 |
| 1538640438 | Ashlee Nicole Alfonso | Counselor | 4990 Williams Ave, La Mesa, CA 91942-7409 | 2018-08-28 |
| 1508343054 | Donna Lynn Morgan | Registered Nurse | 4990 Williams Ave, La Mesa, CA 91942-7409 | 2018-07-26 |
| 1013494749 | Vanessa Elayne Farrior I | Counselor | 4990 Williams Ave, La Mesa, CA 91942-7409 | 2018-07-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902453723 | Nicole V Zappelli | Case Manager/Care Coordinator | 4990 William Ave., La Mesa, CA 91942 | 2019-08-26 |
| 1770059834 | Natalie Ngoc Nguyen | Physician Assistant | 5555 Grosmont Center Dr., La Mesa, CA 91942 | 2018-10-16 |
| 1194204297 | Courtney Pietsch | Nurse Practitioner | 8851 Health Center Circle, Suite #603, La Mesa, CA 91942 | 2018-08-09 |
| 1295214773 | Megan Gordon | Behavior Technician | 6116 Horton Dr, La Mesa, CA 91942 | 2018-08-07 |
| 1356836548 | Kimberly Denise Davis | Counselor | 3845 Avocado School Road, El Cajon, CA 91942 | 2018-06-29 |
| 1366932113 | Melanie Joyce Shepard | Physician Assistant | 7051 Alvarado Road, Suite 201, La Mesa, CA 91942 | 2018-05-17 |
| 1871013532 | Low Dental, A.p.c. | Public Health or Welfare | 7872 La Mesa Blvd., La Mesa, CA 91942 | 2017-06-23 |
| 1275069437 | Ardel Ayala | Respiratory Therapist, Registered | 5800 Lake Murray Blvd. Unit 15, La Mesa, CA 91942 | 2017-05-10 |
| 1285007583 | Counseling & Behavioral Specialists | Marriage & Family Therapist | 5520 Wellesley Street, Ste 204, La Mesa, CA 91942 | 2015-11-09 |
| 1285001875 | Emily Shozaki Rizo | Nurse Practitioner | 6285 Meadowcrest Drive, La Mesa, CA 91942 | 2015-08-31 |
| Find all providers in zip 91942 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881209351 | Carole Oneil | Counselor | 7373 University Ave Ste 201, La Mesa, CA 91942-0524 | 2020-09-11 |
| 1972842631 | Dena Naif | Counselor | 11119 Lalani Dr, La Mesa, CA 91941-8209 | 2013-01-31 |
| 1962690347 | Edna Beth Reynolds II | Counselor | 4490 Williams Ave, La Mesa, CA 91942 | 2007-10-10 |
| 1952916215 | Rachelle Benson | Counselor | 7373 University Ave Ste 201, La Mesa, CA 91942-0524 | 2020-09-14 |
| 1073128559 | Willie Benson | Counselor | 7373 University Ave Ste 201, La Mesa, CA 91942-0524 | 2020-09-11 |
| 1437716933 | Mary French Wynne | Counselor | 7474 El Cajon Blvd, La Mesa, CA 91942-7420 | 2019-05-21 |
| 1598251829 | Anat Mor Betzalel | Counselor | 4990 Williams Ave, La Mesa, CA 91942-7409 | 2018-07-10 |
| 1841792645 | Irean Hilt | Counselor | 8058 La Mesa Blvd, La Mesa, CA 91942 | 2018-03-07 |
| 1972044576 | Graciela Ruiz | Counselor | 8376 Hercules St, La Mesa, CA 91942-2902 | 2017-03-15 |
| 1063866879 | Frederick Luciano | Counselor | 4990 Williams Ave, La Mesa, CA 91942-7409 | 2016-04-18 |
| Find all providers in LA MESA | ||||
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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.