NPIMap

Organization Active NPI

Jackson House El Centro

  • Mental Health Counselor
  • El Centro, CA
National Provider Identifier
1063369528
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
JACKSON HOUSE EL CENTRO
Practice address
2364 S 2ND St
El Centro, CA 92243-9642
Phone
(760) 332-3303
Fax
(760) 332-1463
NPI assigned
Mar 13, 2026
Last updated
Mar 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Carolina Rivas, AMFT
Title
Counselor
Phone
(760) 332-3303

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

2364 S 2ND St
El Centro, CA 92243-9642

Mailing address

2364 S 2ND St
El Centro, CA 92243-9642
Phone (760) 332-3303

National Provider Directory

National Provider Directory

Locations

2364 S 2nd St
El Centro, CA 92243
Phone (760) 332-1468

Practitioners & affiliated clinicians

Practitioners 46

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 46

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1773360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773360000000",
    "number": "1063369528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2364 S 2ND ST",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922439642",
            "telephone_number": "760-332-3303",
            "fax_number": "760-332-1463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2364 S 2ND ST",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922439642",
            "telephone_number": "760-332-3303",
            "fax_number": "760-332-1463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON HOUSE EL CENTRO",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-13",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A",
        "authorized_official_last_name": "RIVAS",
        "authorized_official_first_name": "CAROLINA",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "760-332-3303",
        "authorized_official_credential": "AMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Centro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.