Active NPI
Melissa Jackson
- Behavior Analyst
- San Jose, CA
National Provider Identifier
1780176636
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 1101 S Winchester Blvd Ste N-260
San Jose, CA 95128 - Phone
- (408) 689-4900
- NPI assigned
- Jun 5, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
1101 S Winchester Blvd Ste N-260
San Jose, CA 95128
Mailing address
2730 Shadelands Dr BLDG 10
Walnut Creek, CA 94598-2538
Other practice location 1
200 N Vineyard Blvd Ste A600
Honolulu, HI 96817-3950
Phone (808) 523-8188
Other practice location 2
200 N Vineyard Blvd Ste A600
Honolulu, HI 96817-3950
Phone (808) 523-8188
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569974400000",
"number": "1780176636",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2730 SHADELANDS DR BLDG 10",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945982538"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 S WINCHESTER BLVD STE N-260",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "95128",
"telephone_number": "408-689-4900"
}
],
"practiceLocations": [
{
"address_1": "200 N Vineyard Blvd Ste A600",
"address_purpose": "LOCATION",
"city": "Honolulu",
"state": "HI",
"postal_code": "968173950",
"country_code": "US",
"telephone_number": "808-523-8188",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "200 N Vineyard Blvd Ste A600",
"address_purpose": "LOCATION",
"city": "Honolulu",
"state": "HI",
"postal_code": "968173950",
"country_code": "US",
"telephone_number": "808-523-8188",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACKSON",
"first_name": "MELISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-05",
"last_updated": "2019-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.