Alisa Mae Jackson

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

Practice address

1848 Willow Pass Rd Ste 207
Concord, CA 94520-2542

Phone

(510) 637-8188

NPI assigned

Apr 20, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mountain Valley Child and Family Services, Inc.

  • Community/Behavioral Health Agency
  • Concord, CA
  • NPI 1063985794
  NPD (past)

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

{
    "created_epoch": "1650412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1346983905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24085 AMADOR ST FL 4",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945441226",
            "telephone_number": "510-670-8483",
            "fax_number": "510-670-6444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1848 WILLOW PASS RD STE 207",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945202542",
            "telephone_number": "510-637-8188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2053 Cardiff Dr",
            "address_purpose": "LOCATION",
            "city": "Pittsburg",
            "state": "CA",
            "postal_code": "945654051",
            "country_code": "US",
            "telephone_number": "510-637-8188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ALISA",
        "middle_name": "MAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-20",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Imara Jackson-Goudy
• Ariel Jackson-Linvel
• Lynor Elizabeth Jackson-Marks, L.C.S.W., PSY.D.
• Bethany N Jackson-Russo
• Ajani Dechaun Jackson, MD
• Angilia Jackson
• Ariana Jackson
• Christa Marie Jackson
• Donna M Jackson
• Emily Madison Jackson

• Rehabilitation Practitioner in Concord, CA
• Providers in Concord, CA by specialty
• Rehabilitation Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; 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.