WILLIAM ROLAND JACKSON (NPI# 1912231721) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912231721 |
| Entity Type | Individual |
| Full Name | WILLIAM ROLAND JACKSON |
| Practice Address |
2772 S. Mlk Blvd. Fresno CA 93706-5345 |
| Mailing Address |
5571 W Holland Ave Fresno CA 93722-3758 |
| Practice Telephone | 5592654800 |
| Practice Fax Number | 5592654823 |
| Mailing Telephone | 5592763559 |
| Mailing Fax Number | 5592763559 |
| Enumeration Date | 2009-09-25 |
| Last Update Date | 2009-09-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| 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 |
|---|---|---|---|---|
| 1376901603 | William Jackson | Case Manager/Care Coordinator | 1001 W Broadway Ste B, Farmington, NM 87401-5638 | 2016-02-01 |
| 1104237338 | William Jackson | Surgery | 101 S Ravenel St Ste 230, Florence, SC 29506-2624 | 2014-05-09 |
| 1851646129 | William Jackson | Specialist | 5 Shorewood Ln, Centerport, NY 11721-1731 | 2012-07-23 |
| 1083904502 | William Materson Jackson | Registered Nurse | 1730 Brunswick Dr, Blacksburg, VA 24060-1988 | 2011-04-18 |
| 1427290667 | William E Jackson | Physician Assistant | 9261 E Northview Ct, Tucson, AZ 85749-9792 | 2009-04-02 |
| 1487846366 | William Bradley Jackson | Physical Therapy Assistant | 176 Division St, Great Barrington, MA 01230-1179 | 2007-08-14 |
| 1316144215 | William Lorenzo Jackson | Internal Medicine | 300 Rodgers Blvd, Terminal Box Unit-67, Honolulu, HI 96819-1890 | 2007-07-02 |
| 1366585226 | William Spencer Jackson | Counselor | 880 W 12th St, Reno, NV 89503-2601 | 2007-02-14 |
| 1417006594 | William Kenneth Jackson | Dentist | 11411 N Central Expy Ste K, Dallas, TX 75243-6606 | 2007-01-09 |
| 1326109661 | William Jackson Jr. | Optometrist | 4 West Way Court, Lake Jackson, TX 77566-5242 | 2006-12-12 |
| Street Address |
2772 S. MLK BLVD. |
| City | FRESNO |
| State | CA |
| Zip Code | 93706-5345 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1003374539 | Jasmine Elizabeth Flores | Counselor | 2772 S Martin Luther King Junior Blvd, Fresno, CA 93706 | 2019-03-04 |
| 1063982049 | Bruno Sivongxay | Counselor | 2772 South Martin L King Jr Blvd, Fresno, CA 93706 | 2018-12-03 |
| 1821567538 | Misty Dawn Shepherd | Counselor | 2772 Martin L King Blvd, Fresno, CA 93706 | 2018-11-26 |
| 1497224125 | Jose Jimenez | Counselor | 2772 Martin L. King Blvd, Fresno, CA 93706 | 2018-11-26 |
| 1023587730 | James John Pokorny IIi | Counselor | 2772 Martin L. King Blvd, Fresno, CA 93706 | 2018-11-26 |
| 1932574225 | Brandi Leos | Counselor | 2772 Mlk Jr. Blvd, Fresno, CA 93706 | 2015-12-11 |
| 1174998199 | Jeremiah Hinojosa | Counselor | 2772 S M.l.k. Jr Blvd, Fresno, CA 93706 | 2015-12-02 |
| 1538534557 | Megan Mahoney | Counselor | 2772 S Martin Luther King Jr Blvd, Fresno, CA 93706 | 2015-12-02 |
| Find all providers in zip 93706 | ||||
| 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.