Ajani Dechaun Jackson, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A131170 Issued in CA

Practice address

1959 Solano Way
Concord, CA 94520-5526

Phone

(925) 676-9768

NPI assigned

Aug 2, 2009

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• San Joaquin Behavioral Health Services

  • Community/Behavioral Health Agency
  • Stockton, CA
  • NPI 1215028931
  Medicare reassignment
• County of San Joaquin

  • Multi-Specialty Clinic/Center
  • Manteca, CA
  • NPI 1417407636
  NPD
• San Joaquin County Behavioral Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Stockton, CA
  • NPI 1447467725
  NPD

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

{
    "created_epoch": "1249171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778198400000",
    "number": "1740411214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4961",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957620027",
            "telephone_number": "404-717-2168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 SOLANO WAY",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945205526",
            "telephone_number": "925-676-9768"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4641 Post St Unit 4961",
            "address_purpose": "LOCATION",
            "city": "El Dorado Hls",
            "state": "CA",
            "postal_code": "957623063",
            "country_code": "US",
            "telephone_number": "404-717-2168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "AJANI",
        "middle_name": "DECHAUN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-02",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A131170",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "150257",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "94-2209679",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emely Jacinto
• Imara Jackson-Goudy
• Ariel Jackson-Linvel
• Lynor Elizabeth Jackson-Marks, L.C.S.W., PSY.D.
• Bethany N Jackson-Russo
• Alisa Mae Jackson
• Angilia Jackson
• Ariana Jackson
• Christa Marie Jackson
• Donna M Jackson

• Psychiatry Physician in Concord, CA
• Providers in Concord, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.