Pamela Elaine Jackson, CAS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

C031390315 Issued in CA

Practice address

7200 Bancroft Ave Ste 176
Oakland, CA 94605-2411

Phone

(510) 568-2432

Fax

(510) 568-3912

NPI assigned

Nov 5, 2015

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

State licenses

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.

• Bibett

  • Community/Behavioral Health Agency
  • Oakland, CA
  • NPI 1295925550
  NPD (past)

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

{
    "created_epoch": "1446681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446681600000",
    "number": "1417320995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 BANCROFT AVE STE 176",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946052411",
            "telephone_number": "510-568-2432",
            "fax_number": "510-568-3912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 BANCROFT AVE STE 176",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946052411",
            "telephone_number": "510-568-2432",
            "fax_number": "510-568-3912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "PAMELA",
        "middle_name": "ELAINE",
        "name_prefix": "Ms.",
        "credential": "CAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-05",
        "last_updated": "2015-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "C031390315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mikel James Jackson, ATC
• Monique Quai Jackson
• Nathaniel Jackson, RN
• Nedra Renae Jackson, LCSW, CADC-CAS I
• Nicole C. Jackson, LCSW
• Paul A Jackson, PH.D.
• Randall Michael Jackson, PHARMD RPH
• Rebekah Hope Jackson, M.S., OTR/L
• Sasha Jackson
• Shane Loran Jackson, DPT

• Addiction (Substance Use Disorder) Counselor in Oakland, CA
• Providers in Oakland, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; 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.