Jack McNertney Jr., RAS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

M1307231136 Issued in CA

Practice address

PO Box 1164
Hoopa, CA 95546-1164

Phone

(760) 453-8255

NPI assigned

Apr 8, 2015

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 8, 2026.

{
    "created_epoch": "1428451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780876800000",
    "number": "1821484643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1164",
            "city": "HOOPA",
            "state": "CA",
            "postal_code": "955461164",
            "telephone_number": "760-744-2104",
            "fax_number": "760-744-1382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 1164",
            "city": "HOOPA",
            "state": "CA",
            "postal_code": "955461164",
            "telephone_number": "760-453-8255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNERTNEY",
        "first_name": "JACK",
        "name_suffix": "Jr.",
        "credential": "RAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-08",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "M1307231136",
            "primary": true
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimaiw Med CNTR
• Klamath-Trinity Joint Unified School District
• Yolanda L Latham
• Jena Marshall
• Jesse Clayton McCovey Sr., PEER SUPPORT
• Taushona Lee Anna Moon
• Deborah Carsley Romero, FNP. BC., CDE
• Aran Ruiz, M.S, PPSC
• Eric Ruiz
• Melissa J Ruiz, MSW, PPS-SSW

• All providers in Hoopa, CA
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; 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.