JEFFREY S JACKSON (NPI# 1164457172) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164457172 |
| Entity Type | Individual |
| Full Name | JEFFREY S JACKSON |
| Practice Address |
314 Moore Building University Park PA 16802 |
| Practice Telephone | 8148652191 |
| Practice Fax Number | 8148631331 |
| Mailing Telephone | 8148652191 |
| Mailing Fax Number | 8148631331 |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PS005143L | PA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578193181 | Jeffrey Jackson | Student in an Organized Health Care Education/Training Program | 1055 W Longfellow Dr, Manteno, IL 60950-9472 | 2020-01-22 |
| 1881259570 | Jeffrey Lamar Jackson II | Chiropractor | 13865 S Dixie Hwy # 307, Miami, FL 33176-7221 | 2019-05-08 |
| 1548753965 | Jeffrey Jackson | Social Worker | 2024 Corporate Centre Dr Ste 103, Myrtle Beach, SC 29577-7410 | 2018-06-11 |
| 1154792422 | Jeffrey Scott Jackson | Occupational Therapy Assistant | 3209 Bristol Hwy., Nhc Healthcare, Johnson City, TN 37601 | 2015-10-13 |
| 1447481205 | Jeffrey Brown Jackson | Marriage & Family Therapist | 450 N University Ave, Suite 204, Provo, UT 84601-2860 | 2009-07-28 |
| 1952421927 | Jeffrey W Jackson | Pharmacist | 5510 Lafayette Rd Ste 260, Indianapolis, IN 46254-1691 | 2007-03-30 |
| 1659432607 | Jeffrey L Jackson | Internal Medicine | 500o W National Ave, Milwaukee, WI 53295-0001 | 2006-12-13 |
| 1760589477 | Jeffrey Scott Jackson | Pharmacist | 16821 Rosman Hwy, Lake Toxaway, NC 28747-9593 | 2006-09-17 |
| 1194764860 | Jeffrey Kline Jackson | Family Medicine | 2200 W Touhy Ave, Chicago, IL 60645-3412 | 2006-06-06 |
| 1972563443 | Jeffrey A Jackson | Internal Medicine | 720 Eskenzi Ave., Indianapolis, IN 46202-5166 | 2006-03-27 |
| Street Address |
314 MOORE BUILDING |
| City | UNIVERSITY PARK |
| State | PA |
| Zip Code | 16802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073546503 | Louis Georges Castonguay | Psychologist | 314 Moore Building, University Park, PA 16802 | 2006-07-08 |
| 1952597122 | Jose Angel Soto | Psychologist | 314 Moore Building, University Park, PA 16802 | 2007-09-20 |
| 1245375807 | Frank Gerard Hillary | Psychologist | 314 Moore Building, University Park, PA 16802 | 2007-02-21 |
| 1386784593 | The Pennsylvania State University | Public Health or Welfare | 314 Moore Building, University Park, PA 16802-3103 | 2007-02-07 |
| 1851450704 | William J Ray | Psychologist | 314 Moore Building, University Park, PA 16802 | 2006-12-07 |
| 1497764427 | Aaron Lee Pincus | Psychologist | 314 Moore Building, University Park, PA 16802 | 2006-08-07 |
| 1306855333 | Kristen M Kelly | Psychologist | 314 Moore Building, University Park, PA 16802 | 2006-08-07 |
| 1356376362 | Clifford M Evans | Psychologist | 314 Moore Building, University Park, PA 16802 | 2006-07-11 |
| 1720013634 | Mary A Boutselis | Psychologist | 314 Moore Building, University Park, PA 16802 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134733215 | Erin Marie Mosser | Licensed Practical Nurse | 1 Eisenhower Drive, Student Health Services, University Park, PA 16802 | 2020-09-04 |
| 1063034569 | Benjamin Reese | Specialist/Technologist | 201 Curtin Rd, University Park, PA 16802 | 2020-05-07 |
| 1740801240 | Selah Nicole Whisenant | Specialist/Technologist | Burrowes Rd, University Park, PA 16802 | 2020-05-06 |
| 1659992774 | Shane Jeffrey Angle | Specialist/Technologist | Rec Hall, Burrowes Road, University Park, PA 16802 | 2020-04-29 |
| 1497383962 | Valerie Ann Fulton | Registered Nurse | Penn State University University Health Services, Student Health Center, University Park, PA 16802 | 2020-03-31 |
| 1871155929 | Monica Rosensteel | Licensed Practical Nurse | 1 Eisenhower Dr, University Park, PA 16802 | 2019-06-28 |
| 1609430636 | Adriana Sladich | Specialist/Technologist | 201 Curtain Rd, University Parks, PA 16802 | 2019-04-25 |
| 1073177168 | Sara Bowman | Licensed Practical Nurse | 1 Eisenhower Road, University Park, PA 16802 | 2019-04-24 |
| 1538632468 | Amy Dyanna Marshall | Psychologist | 140 Moore Building, Department of Psychology, University Park, PA 16802 | 2019-01-03 |
| 1083192496 | Raymond J Champagne II | Specialist/Technologist | Penn State Sports Medicine, 109 Lasch Building, University Park, PA 16802 | 2018-07-30 |
| Find all providers in zip 16802 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942668470 | Janice G. Young, Ph.d. | Psychologist | 6417 Grand Point Ave, University Park, FL 34201-2122 | 2016-01-28 |
| 1417961863 | Brian Alan Rabian | Psychologist | 314 Moore Bldg, University Park, PA 16802-3103 | 2006-07-28 |
| 1073546503 | Louis Georges Castonguay | Psychologist | 314 Moore Building, University Park, PA 16802 | 2006-07-08 |
| 1104305614 | Martha Wadsworth | Psychologist | 314 Moore Bldg, University Park, PA 16802-3103 | 2018-08-07 |
| 1598241465 | Sandra Testa Michelson | Psychologist | 314 Moore Bldg, University Park, PA 16802-3103 | 2018-07-13 |
| 1952597122 | Jose Angel Soto | Psychologist | 314 Moore Building, University Park, PA 16802 | 2007-09-20 |
| 1245375807 | Frank Gerard Hillary | Psychologist | 314 Moore Building, University Park, PA 16802 | 2007-02-21 |
| 1851450704 | William J Ray | Psychologist | 314 Moore Building, University Park, PA 16802 | 2006-12-07 |
| 1497764427 | Aaron Lee Pincus | Psychologist | 314 Moore Building, University Park, PA 16802 | 2006-08-07 |
| 1306855333 | Kristen M Kelly | Psychologist | 314 Moore Building, University Park, PA 16802 | 2006-08-07 |
| Find all providers in UNIVERSITY PARK | ||||
| City | UNIVERSITY PARK |
| Zip Code | 16802 |
Please comment or provide details below to improve the information on JEFFREY S JACKSON.
| 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.