Active NPI
Darcel Denise Jackson
- Addiction (Substance Use Disorder) Counselor
- Costa Mesa, CA
National Provider Identifier
1144712696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 12043
- Practice address
- 275 Victoria St Ste 1H
Costa Mesa, CA 92627-1906 - Phone
- (949) 629-2862
- NPI assigned
- May 31, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 12043 | CA | Primary |
Addresses
Primary practice location
275 Victoria St Ste 1H
Costa Mesa, CA 92627-1906
Mailing address
275 Victoria St Ste 1H
Costa Mesa, CA 92627-1906
Phone (949) 629-2862
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783468800000",
"number": "1144712696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "275 VICTORIA ST STE 1H",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926271906",
"telephone_number": "949-629-2862"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 VICTORIA ST STE 1H",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926271906",
"telephone_number": "949-629-2862"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "DARCEL",
"middle_name": "DENISE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-31",
"last_updated": "2026-07-08",
"certification_date": "2026-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "12043",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.