Alexander Enacio Jackson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS19196 Issued in CA

Practice address

7200 Bancroft Ave
Suite 125-D, Alameda County BHCS
Oakland, CA 94605-2403

Phone

(510) 777-3877

Fax

(510) 777-3880

NPI assigned

Jul 20, 2006

Sex

Male

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)

Enrolled

State licenses

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240876800000",
    "number": "1801816244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 PARK BOULEVARD WAY",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946102837",
            "telephone_number": "510-530-0767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 BANCROFT AVE",
            "address_2": "SUITE 125-D, ALAMEDA COUNTY BHCS",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946052403",
            "telephone_number": "510-777-3877",
            "fax_number": "510-777-3880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ALEXANDER",
        "middle_name": "ENACIO",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2009-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS19196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jackie Dong DDS Inc. (Oakland Dental Associates)
• Tenaya Jackman, L.M.
• Debra F Jacks, RAS
• Ceasar Jackson III
• Aaron J Jackson II
• Anthone Duriel Jackson, LMFT
• Artenesha L Jackson, MSW, ASW
• Aujanae Jackson
• Bahati Jackson
• Camille Jackson, M.D.

• Clinical Social Worker in Oakland, CA
• Providers in Oakland, CA by specialty
• Clinical Social Worker in California

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