Jerome Ester Jackson, PHD

Primary specialty

Pastoral CounselorTaxonomy code 101YP1600X

Practice address

3838 N West Ave
Fresno, CA 93705-2703

Phone

(559) 307-3482

Fax

(559) 294-0303

NPI assigned

Oct 6, 2009

Last updated

Oct 6, 2009By the provider in NPPES

Sex

Male

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

Credentials

Doctor of Philosophy

Practice roles

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

• Antioch Substance Abuse Programs

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Fresno, CA
  • NPI 1649507484
  NPD (past) Authorized official

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

{
    "created_epoch": "1254787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254787200000",
    "number": "1518292796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2515 MAGNOLIA AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936118947",
            "telephone_number": "559-307-3482",
            "fax_number": "559-294-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 N WEST AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937052703",
            "telephone_number": "559-307-3482",
            "fax_number": "559-294-0303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JEROME",
        "middle_name": "ESTER",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-06",
        "last_updated": "2009-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cylinda Jackson
• Desha Dione Jackson, LMFT
• Grace Elizabeth Jackson, MD
• Jalisa Jackson
• Jeanette Jackson
• Kendra Y Jackson, LVN
• Kimberly Jackson
• Kourtney Jackson, MS, OTR/L
• Lamarr Jackson
• Lisa Jackson

• Pastoral Counselor in Fresno, CA
• Providers in Fresno, CA by specialty
• Pastoral Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.