Organization Active NPI

Kingdom Builders Transitional Housing Program

  • Substance Abuse Rehabilitation Facility
  • Oakland, CA
National Provider Identifier
1558178665
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
KINGDOM BUILDERS TRANSITIONAL HOUSING PROGRAM
Practice address
2321 International Blvd
Oakland, CA 94601-1018
Phone
(510) 326-2446
NPI assigned
Dec 12, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Authorized official

Name
Dr. Ernest L Jackson, DMIN
Title
Director
Phone
(415) 860-6767

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Pastoral CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP1600X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Case Management Agency 251B00000X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Adult Care Home Facility 311ZA0620X
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

2321 International Blvd
Oakland, CA 94601-1018

Mailing address

2321 International Blvd
Oakland, CA 94601-1018
Phone (510) 326-2446

Other names 1

  • Kingdom Builders Transitional Housing Other name

National Provider Directory

National Provider Directory

Locations

2321 International Blvd
Oakland, CA 94601
Phone (510) 326-2446

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1733961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747353600000",
    "number": "1558178665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2321 INTERNATIONAL BLVD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946011018",
            "telephone_number": "510-326-2446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2321 INTERNATIONAL BLVD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946011018",
            "telephone_number": "510-326-2446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGDOM BUILDERS TRANSITIONAL HOUSING PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-12",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "415-860-6767",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMIN"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kingdom Builders Transitional Housing",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Kingdom Builders Transitional Housing",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.