BROOKE P JACKSON PSYCHOLOGIST (NPI# 1144838913) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144838913 |
| Entity Type | Organization |
| Organization Name | BROOKE P JACKSON PSYCHOLOGIST |
| Practice Address |
1044 Sir Francis Drake Blvd Ste 1 Kentfield CA 94904-1454 |
| Practice Telephone | 4156092361 |
| Mailing Telephone | 4156092361 |
| Enumeration Date | 2020-07-17 |
| Last Update Date | 2020-07-17 |
| Authorized Official Name | BROOKE P JACKSON (OWNER) |
| Authorized Official Telephone | 4156092361 |
| Authorized Official Credential | PSYD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Street Address |
1044 SIR FRANCIS DRAKE BLVD STE 1 |
| City | KENTFIELD |
| State | CA |
| Zip Code | 94904-1454 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295382372 | Stacey Nicole Drew | Occupational Therapist | 4 Ash Ave, Unit 10, Kentfield, CA 94904 | 2019-08-22 |
| 1154781631 | Harvey Sparks | Specialist/Technologist, Other | 350 Bon Air, Ste 100, Greenbrae, CA 94904 | 2016-02-26 |
| 1396120481 | Tamena Potts | Counselor | 1109 Sir Francis Drake, Kentfield, CA 94904 | 2015-07-30 |
| 1598014763 | Rupali Ray Chaudhuri | Nurse Practitioner | 1341 S. Eliseo Dr, Suite 200, Greenbrae, CA 94904 | 2012-09-04 |
| 1326304809 | Lucy Yingxin Zhang | Ophthalmology | 900 S Eliseo Dr Ste 102, Greenbrae, CA 94904 | 2012-04-09 |
| 1396073185 | Bonnie Louise Hoag | Marriage & Family Therapist | 905 Sir Francis Drake Blvd., Ste. F., Kentfield, CA 94904 | 2009-12-07 |
| 1801043880 | Alexander Vogel Uihlein | Internal Medicine | 900 S Eliseo Dr Ste 201, Greenbrae, CA 94904 | 2008-08-21 |
| 1649426115 | Marilyn Thatcher | Psychologist | 1010 Sir Francis Drake Blve, Ste. 103, Kentfield, CA 94904 | 2008-08-14 |
| 1205007598 | Sir Francis Drake Dental | Dentist | 919 Sir Francis Drake Blvd, Kentfield, CA 94904 | 2008-03-14 |
| 1841401734 | Rishi K Wadhwa | Neurological Surgery | 1100 S Eliseo Dr Ste 1, Greenbrae, CA 94904 | 2007-05-24 |
| Find all providers in zip 94904 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871703629 | Vicki L.c. Weatherford | Psychologist | 1010 Sir Francis Drake Blvd Ste 2, Kentfield, CA 94904-1444 | 2007-05-23 |
| 1003033267 | Myra Gueco Bernecker | Psychologist | 1036 Sir Francis Drake Blvd Ste 204, Kentfield, CA 94904-1440 | 2007-04-19 |
| 1568538395 | Carole J Marks | Psychologist | 1030 Sir Francis Drake Blvd Ste 100, Kentfield, CA 94904-1411 | 2006-11-24 |
| 1467425025 | Diana Sanborn | Psychologist | 1030 Sf Drake Blvd, Suite 100-2, Kentfield, CA 94904-1411 | 2006-02-13 |
| 1649722216 | Chloe A. Martin | Psychologist | 1030 Sir Francis Drake Blvd, Suite 100, Room 1, Kentfield, CA 94904-1411 | 2016-10-31 |
| 1063759116 | Joan Driscoll | Psychologist | 1036 Sir Francis Drake Blvd, Suite 200, Kentfield, CA 94904-1427 | 2013-01-09 |
| 1356643738 | Dedalus Hyde | Psychologist | 1036 Sir Francis Drake Blvd, Kentfield, CA 94904-1427 | 2010-11-17 |
| 1760702856 | Danila Musante | Psychologist | 835 College Ave, Kentfield, CA 94904-2551 | 2010-06-11 |
| 1962665067 | Brooke P Jackson | Psychologist | 1044 Sir Francis Drake Blvd, Suite 1, Kentfield, CA 94904-1449 | 2008-07-08 |
| 1508041229 | Robert Philippe Reiser | Psychologist | 1036 Sir Francis Drake Blvd, Kentfield, CA 94904-1427 | 2007-12-31 |
| Find all providers in KENTFIELD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.