Shardonay Alayia Jackson

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

27777 Inkster Rd Ste 100
Farmington Hills, MI 48334-5312

Phone

(510) 692-7020

NPI assigned

Feb 28, 2022

Last updated

Aug 8, 2022By 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

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

{
    "created_epoch": "1646006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1811643836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9244 MACARTHUR BLVD APT 1",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946054354",
            "telephone_number": "510-692-7020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27777 INKSTER RD STE 100",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483345312",
            "telephone_number": "510-692-7020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "39201 State St",
            "address_purpose": "LOCATION",
            "city": "Fremont",
            "state": "CA",
            "postal_code": "945381437",
            "country_code": "US",
            "telephone_number": "866-206-2008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SHARDONAY",
        "middle_name": "ALAYIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-28",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shanikka Jackson
• Shanise A Jackson
• Shanita Jackson
• Shannon Maria Jackson
• Shantinique Jackson
• Simone Jackson
• Sky Jackson
• Sonya Jackson
• Steven Jackson
• Tana Jackson

• Behavior Technician in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Behavior Technician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; 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.