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).
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 |
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 |
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 |
Street Address |
939 N D ST |
City | SAN BERNARDINO |
State | CA |
Zip Code | 92410-3519 |
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 |
Find all providers in the same location |
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 Code | 175T00000X |
Grouping | Other Service Providers |
Classification | Peer Specialist |
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] |
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 |
City | SAN BERNARDINO |
Zip Code | 92410 |
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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.