RONALD WAYNE JACKSON


Address: 939 N D St, San Bernardino, CA 92410-3519
Phone: 9098896519

RONALD WAYNE JACKSON (NPI# 1922647346) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1922647346
Entity Type Individual
Full Name RONALD WAYNE JACKSON
Credential RADT
Practice Address 939 N D St
San Bernardino
CA 92410-3519
Mailing Address 1260 E Arrow Hwy
Upland
CA 91786-4982
Practice Telephone 9098896519
Mailing Telephone 9099321069
Enumeration Date 2020-01-02
Last Update Date 2020-10-27
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 405300000X Prevention Professional RADT78265 CA Other Service Providers
Y 175T00000X Peer Specialist Other Service Providers

Other Providers RONALD JACKSON

NPI Name Taxonomy Address Enumeration
1285864520 Ronald B Jackson Physical Therapist 116 Dawson St, Edinburg, TX 78539 2009-07-21
1972732717 Ronald Joseph Jackson Massage Therapist 450 Lewis St., Pagosa Springs, CO 81147 2009-07-14
1689866857 Ronald Eliot Jackson Physical Therapy Assistant 11615 Basket Xing, San Antonio, TX 78245-3375 2007-08-13
1285857680 Ronald Evans Jackson Chiropractor 310 Quinlan St, Kerrville, TX 78028-4411 2007-04-11
1285762690 Ronald Todd Jackson Dentist 1803 University Blvd N, Jacksonville, FL 32211-4523 2007-02-28
1548281017 Ronald Corey Jackson Dentist 2365 N Mount Juliet Rd, Mt Juliet, TN 37122-3038 2006-07-21
1447867221 Ronald Earl Jackson Jr. Behavior Technician 7109 Danny Dr, Stockton, CA 95210-5320 2020-09-25
1578109229 Ronald Jackson Rehabilitation Practitioner 1515 E Tropicana Ave Ste 375, Las Vegas, NV 89119-6520 2019-11-18
1841758869 Ronald L Jackson Case Manager/Care Coordinator 3500 Carnegie Ave, Cleveland, OH 44115-2641 2019-03-08
1134676125 Ronald Jackson Social Worker 525 Zane St, Louisville, KY 40203-3203 2016-09-07

Office Location

Street Address 939 N D ST
City SAN BERNARDINO
State CA
Zip Code 92410-3519

Providers in the same location

NPI Name Taxonomy Address Enumeration
1124158498 Vista Guidance Centers, In.c Counselor 939 N D St, San Bernardino, CA 92418-0001 2007-03-06
1568972974 Janice Trina Macias Counselor 939 N D St, San Bernardino, CA 92410-3519 2017-10-11
1336697960 Alexandra Latorre Counselor 939 N D St, San Bernardino, CA 92410-3519 2016-09-12
1407268840 Kim Mclaughlin Counselor 939 N D St, San Bernardino, CA 92410-3519 2014-05-20
1073744660 Inland Valley Drug and Alcohol Recovery Services Clinic/Center 939 N D St, San Bernardino, CA 92410-3519 2009-07-31
1730359019 Nancy Lee Freeman Substance Abuse Rehabilitation Facility 939 N D St, San Bernardino, CA 92410-3519 2008-03-03
1598960874 Vista Recovery Center Counselor 939 N D St, San Bernardino, CA 92418-0001 2007-06-18
1396947156 Donna M Boyd Counselor 939 N D St, San Bernardino, CA 92418-0001 2007-06-04
1124238498 Gloria Palmer Counselor 939 N D St, San Bernardino, CA 92418-0001 2007-05-23
1962612267 Karen Webber Counselor 939 N D St, San Bernardino, CA 92418-0001 2007-05-23
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1902303472 Reina Elora Garcia Student in an Organized Health Care Education/Training Program 775 E Base Line St Spc 4, San Bernardino, CA 92410 2018-04-10
1558889881 Salaunge Lopez Non-emergency Medical Transport (VAN) 25942 Baseline St Apt D203, San Bernardino, CA 92410 2017-09-07
1902328578 Kelly Canady Counselor 1100 N. D St., San Bernardino, CA 92410 2017-07-14
1881058592 Terron Thomas Contractor 445 South G, Unit B, San Bernardino, IN 92410 2016-04-08
1982064572 Zachary Norton-martinez Specialist/Technologist 650 Del Rosa Dr, San Bernardino, CA 92410 2016-02-25
1003280934 Brenda Boyle Nurse Practitioner 1455 East 3rd Street, San Bernardino, CA 92410 2015-11-16
1689045197 Bryan Carter Physician Assistant 1455 E 3rd Street, San Bernardino, CA 92410 2015-10-09
1801270137 Sac Health System Clinic/Center 250 South G Street, San Bernardino, CA 92410 2015-07-16
1467852269 Wilson Dentistry, Inc. Dentist 1063 N. D St, San Bernardino, CA 92410 2014-08-28
1629405345 Terrence John Forrester Social Worker 1455 E. 3rd St, San Bernardino, CA 92410 2013-09-27
Find all providers in zip 92410

Taxonomy Information

Taxonomy Code 175T00000X
Grouping Other Service Providers
Classification Peer Specialist

Taxonomy Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
Notes: Source: National Uniform Claim Committee [7/1/2014: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1437783180 Samuel Guadron Rosales Peer Specialist 658 E Brier Dr Ste 250, San Bernardino, CA 92408-2875 2020-03-02
1518502301 Georgina Centeno Peer Specialist 780 Esat Gilbert St, San Bernardino, CA 92415-0001 2019-11-15
1063920973 Arneta Brown Peer Specialist 658 E Brier Dr, San Bernardino, CA 92415-0928 2018-01-12
1619589140 Michelle Eileen Koperski Peer Specialist 1481 Windsor Dr, San Bernardino, CA 92404-5416 2020-08-17
1518598879 Denise Ybarra Peer Specialist 104 W 4th St, San Bernardino, CA 92415-0035 2020-01-27
1649818055 Sidney Untal Suarez Jr. Peer Specialist 820 E Gilbert St, San Bernardino, CA 92415-0928 2019-12-16
1912543760 Elsie Renee Rollins Peer Specialist 1481 Windsor Dr, San Bernardino, CA 92404-5416 2019-11-26
1841836145 Noe Zepeda Peer Specialist 351 N Mt View Ave, San Bernardino, CA 92415-0001 2019-11-21
1265077341 Demario O'ryan Dunn Peer Specialist 820 E Gilbert St, San Bernardino, CA 92415-1403 2019-11-12
1740825827 Cristina Guerra Peer Specialist 820 E Gilbert St, San Bernardino, CA 92415-1403 2019-11-12
Find all providers in SAN BERNARDINO

Competitor

Search similar providers

City SAN BERNARDINO
Zip Code 92410

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Dataset Information

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.

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