HARRY LEE JACKSON (NPI# 1710467659) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710467659 |
| Entity Type | Individual |
| Full Name | HARRY LEE JACKSON |
| Practice Address |
17845 Ironwood Lane Victorville CA 92395-9239 |
| Mailing Address |
17845 Ironwood Lane Svl Box 8205 Victorville CA 92395 |
| Practice Telephone | 7603736251 |
| Mailing Telephone | 5622300737 |
| Enumeration Date | 2018-08-20 |
| Last Update Date | 2018-08-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336234640 | Harry Keith Jackson | Dentist | 116 Hills Plz, Charleston, WV 25387-2438 | 2006-10-03 |
| 1376505578 | Harry J. Jackson | Dentist | Hqs, Usa Dentac, 4441 Service Drive, Ft Hood, TX 76544-5054 | 2006-04-04 |
| 1457331209 | Harry Jackson | Legal Medicine | 140 Alcott Pl, Bronx, NY 10475-4302 | 2006-01-18 |
| Street Address |
17845 IRONWOOD LANE |
| City | VICTORVILLE |
| State | CA |
| Zip Code | 92395-9239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528607827 | Latoya Monique Jackson | Behavior Technician | 17845 Ironwood Lane, Victorville, CA 92395-5166 | 2020-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043837966 | Desert Ridge Transitional Care Center, Lp | Skilled Nursing Facility | 13300 11th Avenue, Victorville, CA 92395 | 2020-06-26 |
| 1376179093 | Catherine Ward | Speech-Language Pathologist | 13275 Mauka Ct, Victorville, CA 92395 | 2020-03-13 |
| 1174019228 | Laura Mercado Halterman | Family Medicine | 16519 Victor St Ste 307, Victorville, CA 92395 | 2018-07-02 |
| 1306337829 | Stephanie Ann Kruger | Behavior Technician | Sunny Days Inc 3602 Inland Empire Blvd., Ontario, CA 92395 | 2018-05-21 |
| 1861903924 | Debra L Andersen | Clinic/Center | 12830 Hesperia Road, Suite C, D, E, Victorville, CALIFORNIA 92395 | 2017-10-17 |
| 1790202141 | Joshua Powers | Physician Assistant | 12550 Hesperia Rd Ste 101, Victorville, CA 92395 | 2017-08-26 |
| 1043759491 | Kemp Individual & Family Therapy, Inc. | Marriage & Family Therapist | 14075 Hesperia Road, Suite 101, Victorville, CA 92395 | 2017-02-17 |
| 1740725969 | Abem Transportation Inc | Non-emergency Medical Transport (VAN) | 15000 7th St Ste F208, Victorville, CA 92395 | 2016-12-23 |
| 1447669379 | Tracie Girard | Nurse Practitioner | 17330 Bear Valley Road, Suite A106, Victorville, CA 92395 | 2014-08-05 |
| 1093153215 | Mitesh Patel | Surgery | 13010 Hesperia Rd Ste 400, Victorville, CA 92395 | 2013-06-10 |
| Find all providers in zip 92395 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417558974 | Diosa Marriage and Family Therapy PC | Counselor | 14420 Civic Dr Ste 6, Victorville, CA 92392-2384 | 2020-11-02 |
| 1467065789 | Jennifer Alejandra Partida | Counselor | 12650 Sundown Rd, Victorville, CA 92392-7512 | 2020-08-26 |
| 1063078251 | Innerpeace Therapy | Counselor | 15437 Anacapa Rd # 23, Victorville, CA 92392-2458 | 2019-05-14 |
| 1114351954 | Diane Inez Garcia-becker | Counselor | 9075 Svl Box, 12905 Rolling Ridge Drive, Victorville, CA 92395-5146 | 2013-08-28 |
| 1720330897 | Renae Devolld | Counselor | 13748 Valera Way, Victorville, CA 92392-6372 | 2012-10-12 |
| 1295083871 | Stephanie Denise Williams | Counselor | 15095 Amargosa Rd. Suite 201, Victorville, CA 92395 | 2012-08-29 |
| 1902153646 | Charles Nwufo | Counselor | 14338 Park Ave Ste 200, Victorville, CA 92392-2925 | 2012-08-13 |
| 1760760797 | Jacqueline Rene Bond | Counselor | 14318 California Ave, Ste. 101, Victorville, CA 92392-2389 | 2011-07-25 |
| 1275783672 | Ellen-ruby S. Santos | Counselor | 15095 Amargosa Rd Ste 201, Victorville, CA 92394-1868 | 2008-09-23 |
| 1790836542 | Adrian Jinkichi Simmons | Counselor | 15409 Anacapa Rd Ste F, Victorville, CA 92392-2463 | 2007-01-16 |
| Find all providers in VICTORVILLE | ||||
| City | VICTORVILLE |
| Zip Code | 92395 |
Please comment or provide details below to improve the information on HARRY LEE 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.