LISA ANN JACKSON (NPI# 1659980738) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659980738 |
| Entity Type | Individual |
| Full Name | LISA ANN JACKSON |
| Practice Address |
956 E Tabor Ave Fairfield CA 94533-4104 |
| Practice Telephone | 7075551212 |
| Mailing Telephone | 7075551212 |
| Enumeration Date | 2020-07-24 |
| Last Update Date | 2020-07-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 90577107F64129 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598300329 | Lisa Ann Jackson | Speech-Language Pathologist | 802 S Yucatan Dr, Tucson, AZ 85710-4933 | 2019-11-15 |
| 1194292441 | Lisa Jackson | Nurse's Aide | 2423 Montana Blue Dr, Spring, TX 77373-7871 | 2018-10-25 |
| 1770027781 | Lisa Jackson | Registered Nurse | 1520 E Calhoun St, Anderson, SC 29621-2210 | 2016-12-09 |
| 1154711166 | Lisa Jackson | Psychologist | 20111 Horace Harding Expy, Oakland Gardens, NY 11364-1639 | 2015-01-28 |
| 1720493224 | Lisa Nicole Jackson | Specialist/Technologist | 3200 Troup Hwy Ste, 120, Tyler, TX 75701 | 2014-06-24 |
| 1831468420 | Lisa Nicole Jackson | Licensed Practical Nurse | 1599 Prospect Pl Apt 1e, Brooklyn, NY 11233-4451 | 2011-12-28 |
| 1992023030 | Lisa Jackson | Massage Therapist | 7200 Sw 8th Ave Apt 9, Gainesville, FL 32607-1883 | 2010-05-13 |
| 1487844973 | Lisa Nicole Jackson | Obstetrics & Gynecology | 89-06 135th St, Room 6a, Jamaica, NY 11418 | 2007-07-31 |
| 1497828826 | Lisa Lanette Jackson | Nurse Practitioner | 1117 Chestnut St, Lewisville, AR 71845 | 2006-11-15 |
| 1972696516 | Lisa Thompson Jackson | Nurse Anesthetist, Certified Registered | 1500 E. Woodrow Wilson, Jackson, MS 39216 | 2006-10-02 |
| Street Address |
956 E TABOR AVE |
| City | FAIRFIELD |
| State | CA |
| Zip Code | 94533-4104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033262134 | Geraline Gomez | Counselor | 956 E Tabor Ave, Fairfield, CA 94533-4104 | 2007-01-19 |
| 1396361176 | Veronica Garcia | Counselor | 956 E Tabor Ave, Fairfield, CA 94533-4104 | 2020-06-17 |
| 1427609536 | Stephanie Marie Garcia | Counselor | 956 E Tabor Ave, Fairfield, CA 94533-4104 | 2019-09-20 |
| 1972153674 | Leticia Naranjo | Counselor | 956 E Tabor Ave, Fairfield, CA 94533-4104 | 2019-09-13 |
| 1487203618 | Juan A Tinoco | Counselor | 956 E Tabor Ave, Fairfield, CA 94533-4104 | 2019-09-10 |
| 1528616950 | Madison Lanni | Counselor | 956 E Tabor Ave, Fairfield, CA 94533-4104 | 2019-08-28 |
| 1700440302 | Tierra Williams | Counselor | 956 E Tabor Ave, Fairfield, CA 94533-4104 | 2019-04-29 |
| 1578812228 | Ralph B Mahler | Counselor | 956 E Tabor Ave, Fairfield, CA 94533-4104 | 2012-09-07 |
| 1821346214 | Alexandra Kapsiotis | Counselor | 956 E Tabor Ave, Fairfield, CA 94533-4104 | 2012-08-16 |
| 1902080385 | Andrea L Bruce | Counselor | 956 E Tabor Ave, Fairfield, CA 94533-4104 | 2007-12-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609487347 | Shayondelice Sledge | Case Manager/Care Coordinator | 3001 N. Texas St., #27, Fairfield, CA 94533 | 2020-08-16 |
| 1508401191 | Tiffany Ann Garcia | Social Worker | 1301 Roman Way, Martinez, CA 94533 | 2019-11-07 |
| 1609424175 | Andrew Stephens | Student in an Organized Health Care Education/Training Program | Dgmc, 101 Bodin Cir, Fairfield, CA 94533 | 2019-08-28 |
| 1821645383 | Michelle Marie Hackett | Marriage & Family Therapist | 1745 Enterprise Dr., Bldg. 2, Ste 1a, Fairfield, CA 94533 | 2019-08-20 |
| 1780154369 | Maria Leonila Ramos Corpuz | Behavior Technician | 744 Empire Street Suite 160, Fairfield, CA 94533 | 2018-11-27 |
| 1629575303 | Jeanne Ann Kiernan | Dentist | 690 Airman Dr, Apo, AA 94533 | 2018-04-10 |
| 1629596820 | Max Kardos | Student in an Organized Health Care Education/Training Program | 801 Empire St., Fairfield, CA 94533 | 2017-09-07 |
| 1780119867 | Justin Denhart Dickson | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir Fairfield Ca 94533, David Grant Medical Center, Fpo, AA 94533 | 2017-04-26 |
| 1639613409 | Behrooz Shafiezadeh | Marriage & Family Therapist | Caminar, 601 Madison Street, Suite D, Fairfield, CA 94533 | 2016-12-13 |
| 1427500164 | Tanya Ayers | Counselor | 801 Empire Street, Fairfield, CA 94533 | 2016-10-28 |
| Find all providers in zip 94533 | ||||
| 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 |
|---|---|---|---|---|
| 1629675624 | Natasha A Ridosh | Counselor | 2750 N Texas St Unit 7206, Fairfield, CA 94533-1176 | 2020-10-03 |
| 1003424219 | Amanda Kate Tubb | Counselor | 1601 Union Ave Apt 2, Fairfield, CA 94533-3731 | 2020-07-14 |
| 1447877964 | Victoria Larrieu Sebourne | Counselor | 35 Montauk St, Fairfield, CT 06825-1606 | 2020-06-30 |
| 1851913305 | Christian Vazquez | Counselor | 5114 Bickford Cir, Fairfield, CA 94533-6574 | 2020-05-07 |
| 1952923492 | Lionesha Nashell Lewis | Counselor | 701 E Travis Blvd Apt 13, Fairfield, CA 94533-8754 | 2020-05-07 |
| 1922629971 | Juan Carlos Cardenas | Counselor | 877 Sunset Ct, Fairfield, CA 94533-4145 | 2020-04-30 |
| 1518587013 | Jaime Quesada | Counselor | 1357 Astoria Dr, Fairfield, CA 94534-4325 | 2020-04-24 |
| 1871113316 | Scott D Wagner I | Counselor | 319 E Tabor Ave Apt 15319, Fairfield, CA 94533-3955 | 2020-04-24 |
| 1871113597 | Krystal Hill | Counselor | 2999 N Texas St Apt 23, Fairfield, CA 94533-1283 | 2020-04-22 |
| 1922561232 | Johnece M Smith | Counselor | 5010 Gary Ave, Fairfield, AL 35064-1349 | 2019-04-12 |
| Find all providers in FAIRFIELD | ||||
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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.