Active NPI
Tonja M Jackson, MSW
- Counseling Psychologist
- Hayward, CA
National Provider Identifier
1932711413
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- Practice address
- 23213 Lynn St
Hayward, CA 94541-7426 - Phone
- (510) 978-2361
- NPI assigned
- Aug 17, 2020
- Last updated
- Aug 17, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | |||
| Counseling Psychologist | 103TC1900X | Primary | ||
| Clinical Social Worker | 1041C0700X |
Addresses
Primary practice location
23213 Lynn St
Hayward, CA 94541-7426
Mailing address
23213 Lynn St
Hayward, CA 94541-7426
Phone (510) 978-2361
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": "1597622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597622400000",
"number": "1932711413",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23213 LYNN ST",
"city": "HAYWARD",
"state": "CA",
"postal_code": "945417426",
"telephone_number": "510-978-2361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23213 LYNN ST",
"city": "HAYWARD",
"state": "CA",
"postal_code": "945417426",
"telephone_number": "510-978-2361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "TONJA",
"middle_name": "M",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-17",
"last_updated": "2020-08-17",
"certification_date": "2020-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": null,
"license": null,
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hayward, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.