Adriann M Jackson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2716 Freedom Blvd
Corralitos, CA 95076-1027

Phone

(831) 688-6293

Fax

(831) 761-9987

NPI assigned

Apr 17, 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.

• Encompass Community Services

  • Community/Behavioral Health Agency
  • Watsonville, CA
  • NPI 1194955963
  NPD (past)

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317686400000",
    "number": "1497971808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2716 FREEDOM BLVD",
            "city": "CORRALITOS",
            "state": "CA",
            "postal_code": "950761027",
            "telephone_number": "831-688-6293",
            "fax_number": "831-761-9987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2716 FREEDOM BLVD",
            "city": "CORRALITOS",
            "state": "CA",
            "postal_code": "950761027",
            "telephone_number": "831-688-6293",
            "fax_number": "831-761-9987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ADRIANN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2011-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isaiah Graeme Calderon
• Peter Fediay, D.C.
• Heather Alyssa Maurin
• Sarah Nohrden
• Amalia Gonzalez Rosales, MA CCC-SLP
• Shannon Rose
• Robert Cecil Williams, PT

• Mental Health Counselor in Corralitos, CA
• Providers in Corralitos, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; 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.