Jackie Jackson

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

604 W Ocean Ave
Lompoc, CA 93436-6630

Phone

(805) 346-8185

Fax

(805) 346-8656

NPI assigned

Feb 21, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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.

• Good Samaritan Shelter

  • Community/Behavioral Health Agency
  • Lompoc, CA
  • NPI 1225521123
  NPD (past)
• Good Samaritan Shelter, Inc.

  • Substance Abuse Rehabilitation Facility
  • Lompoc, CA
  • NPI 1114176831
  NPD (past)

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250035200000",
    "number": "1356476501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 E COOK ST",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934545750",
            "telephone_number": "805-922-1991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 W OCEAN AVE",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934366630",
            "telephone_number": "805-346-8185",
            "fax_number": "805-346-8656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JACKIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2009-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Buffi Isaac
• Zaena Delilah Isaac, LPC, LPCC
• Sandra Isaacs, RN, PHN
• Ted Matthew Isaacson, MS CCC SLP
• Ayano Itoh
• Mylisa Jackson
• Serena Frances Jackson, RDN
• Taylahni Zhane Jackson
• Renee Louise Ann Jacobsen, MS CCC SLP
• Wendell Blake Jamison, MD

• All providers in Lompoc, CA
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2009; 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.