Michele Denise Jackson, RI-J0808181554

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

RI-J808181554 Issued in CA

Practice address

10700 Macarthur Blvd
Ste 12
Oakland, CA 94605-5298

Phone

(510) 568-2432

Fax

(510) 568-3912

NPI assigned

Jul 27, 2009

Last updated

Jul 27, 2009By the provider in NPPES

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

State licenses

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.

• Bi-Bett

  dba East Oakland Recovery Center

  • Case Management Agency
  • Oakland, CA
  • NPI 1669677803
  NPD (past)

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

{
    "created_epoch": "1248652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248652800000",
    "number": "1740411636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 MACARTHUR BLVD",
            "address_2": "STE 12",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946055298",
            "telephone_number": "510-568-2432",
            "fax_number": "510-568-3912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 MACARTHUR BLVD",
            "address_2": "STE 12",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946055298",
            "telephone_number": "510-568-2432",
            "fax_number": "510-568-3912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MICHELE",
        "middle_name": "DENISE",
        "name_prefix": "Ms.",
        "credential": "RI-J0808181554",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-27",
        "last_updated": "2009-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "RI-J808181554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latisha Nichole Jackson
• Leonard Jackson Jr.
• Mable Lee Jackson
• Marina Marcia Jackson, MFT
• Michael Wayne Jackson, O.D.
• Mikel James Jackson, ATC
• Monique Quai Jackson
• Nathaniel Jackson, RN
• Nedra Renae Jackson, LCSW, CADC-CAS I
• Nicole C. Jackson, LCSW

• Addiction (Substance Use Disorder) Counselor in Oakland, CA
• Providers in Oakland, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.