Donald A Jackson, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY119 Issued in NV

Practice address

Nced Ms 285
University of Nevada, Reno
Reno, NV 89557-1285

Phone

(775) 682-9049

Fax

(775) 784-4997

NPI assigned

Dec 5, 2006

Last updated

Oct 28, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477612800000",
    "number": "1588722466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 54",
            "city": "VERDI",
            "state": "NV",
            "postal_code": "894390054",
            "telephone_number": "775-848-5578",
            "fax_number": "775-784-4997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NCED MS 285",
            "address_2": "UNIVERSITY OF NEVADA, RENO",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895571285",
            "telephone_number": "775-682-9049",
            "fax_number": "775-784-4997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DONALD",
        "middle_name": "A",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2016-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NV",
            "license": "PY119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2616059",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jackalope Holistic Healing LLC
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• Amy Ruth Jackson, CADC
• Angela Jackson, M.S. SLP-CCC
• Barbara Anne Jackson
• Evette M Jackson
• Januari Jackson
• Jason Jackson
• Karen P. Jackson, LCSW, MFT
• Kendra Jackson

• Psychologist in Reno, NV
• Providers in Reno, NV by specialty
• Psychologist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2016; 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.