DR. ANNE ELIZABETH JACKSON (NPI# 1619127537) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619127537 |
| Entity Type | Individual |
| Full Name | DR. ANNE ELIZABETH JACKSON |
| Credential | PH.D. |
| Practice Address |
1101 College Ave Ste 230 Santa Rosa CA 95404-3956 |
| Mailing Address |
712 Bancroft Rd # 771 Walnut Creek CA 94598-1531 |
| Practice Telephone | 6504443260 |
| Mailing Telephone | 6504443260 |
| Enumeration Date | 2008-09-27 |
| Last Update Date | 2017-02-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | PSY17785 | CA | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY17785 | CA | Behavioral Health & Social Service Providers |
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
PSY17785 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174923627 | Anne Martha Jackson | Registered Nurse | 13175 Se Kuehn Rd, Milwaukie, OR 97222-4730 | 2014-09-02 |
| 1891066858 | Anne Jackson | Pharmacist | 1260 Washington St, Blair, NE 68008-1732 | 2012-01-23 |
| 1366616591 | Anne Mccracken Jackson | Counselor | 633 Thompson Ln, Nashville, TN 37204-3616 | 2008-04-18 |
| 1669640017 | Anne Jackson | Physical Therapist | 1155 35th Ln, Ste 100, Vero Beach, FL 32960-6521 | 2008-02-19 |
| 1134208929 | Anne Marie Jackson | Physical Therapist | 3200 Shakerag Hl, Peachtree City, GA 30269-6511 | 2006-11-03 |
| 1497715452 | Anne Meath Jackson | Audiologist | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2006-03-24 |
| Street Address |
1101 COLLEGE AVE STE 230 |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95404-3956 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861613648 | Pamela Ann Loman | Psychologist | 1101 College Ave, Suite 230, Santa Rosa, CA 95404-3956 | 2007-05-01 |
| 1568854727 | North Bay Neuropsychology A Psychology Corporation | Clinical Neuropsychologist | 1101 College Ave, Suite 250, Santa Rosa, CA 95404-3956 | 2015-02-25 |
| 1659625234 | Tracy Lynn Jones | Psychologist | 1101 College Ave, Suite 230, Santa Rosa, CA 95404-3956 | 2012-11-02 |
| 1962652883 | Ellen O'toole | Clinical Neuropsychologist | 1101 College Ave, Suite 250, Santa Rosa, CA 95404-3956 | 2008-09-27 |
| 1285847194 | Caroline Louise Morris | Marriage & Family Therapist | 1101 College Ave, Suite 220, Santa Rosa, CA 95404-3956 | 2007-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205442217 | David Lee Dutton | Counselor | 201 S. E Street, Santa Rosa, CA 95404 | 2020-09-16 |
| 1114492162 | Jesse Earl Rathbun Jr. | Ophthalmology | 1920 Grace Dr., Santa Rosa, CA 95404 | 2018-10-05 |
| 1568958437 | Bianca Avina | Marriage & Family Therapist | 95 Montgomery Dr. #112, Santa Rosa, CA 95404 | 2018-07-03 |
| 1366940504 | New Leaf Counseling and Psychotherapy | Marriage & Family Therapist | 1030 2n Street, Suite B, Santa Rosa, CA 95404 | 2018-01-23 |
| 1659884864 | Jessica Vargas Lopez | Counselor | 3333 Chanate Road, Santa Rosa, CA 95404 | 2017-11-09 |
| 1982135992 | Gaea Keridwyn Coon | Marriage & Family Therapist | 884 Third Street, Suite D, Santa Rosa, CA 95404 | 2017-03-22 |
| 1376084699 | Empire Traditional Chinese Medicine | Acupuncturist | 1030 Second St, Santa Rosa, CA 95404 | 2017-03-20 |
| 1356888705 | Webster Surgery Center, Lp | Clinic/Center | 730 Bennett Valley Road, Santa Rosa, CA 95404 | 2017-01-24 |
| 1205295979 | Sandra Lee Krikorian | Social Worker | 101 E Street, Suite 312, Santa Rosa, CA 95404 | 2016-02-23 |
| 1396134615 | The Center for Body Oriented Psychotherapy & Wellness | Psychologist | 1626 Fourth Street, Santa Rosa, CA 95404 | 2015-01-12 |
| Find all providers in zip 95404 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922574821 | Megan Nolan | Psychologist | 4378 Bennett Valley Rd, Santa Rosa, CA 95404-6239 | 2018-10-17 |
| 1023505344 | Cross Cultural Services and Evaluations, Inc | Psychologist | 1550 Airport Blvd Ste 206, Santa Rosa, CA 95403-1095 | 2018-04-23 |
| 1053764688 | Dominic G Lucia | Psychologist | 1824 Empire Industrial Ct, Suite 'c', Santa Rosa, CA 95403-1991 | 2016-07-19 |
| 1942659024 | Anne Babin | Psychologist | 819 3rd St Ste 103, Santa Rosa, CA 95404-4546 | 2016-06-08 |
| 1649524802 | Sheila Albert | Psychologist | 4911 Perezoso Calle, Santa Rosa, CA 95409-2651 | 2012-11-08 |
| 1730443359 | Silvio Machado | Psychologist | 1626 4th St, Santa Rosa, CA 95404-4020 | 2012-06-28 |
| 1619266343 | Carla Marie Manly | Psychologist | 320 10th St Ste 303, Santa Rosa, CA 95401-5291 | 2011-04-04 |
| 1154638740 | Kimberly A Gauntlett | Psychologist | 657 Connie St, Santa Rosa, CA 95407-6267 | 2010-09-03 |
| 1063740736 | Kathleen A Kunster | Psychologist | 320 Tenth Street, Suite 205, Santa Rosa, CA 95401-9540 | 2009-11-18 |
| 1588801054 | Lisa Rohe | Psychologist | 1008 Fifth Street, Santa Rosa, CA 95404 | 2009-01-20 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95404 |
Please comment or provide details below to improve the information on DR. ANNE ELIZABETH 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.