MRS. KEISHA HOLMES JACKSON


Address: 15095 Amargosa Rd, Suite 201, Victorville, CA 92394-1879
Phone: 7602454695

MRS. KEISHA HOLMES JACKSON (NPI# 1235497553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1235497553
Entity Type Individual
Full Name MRS. KEISHA HOLMES JACKSON
Practice Address 15095 Amargosa Rd
Suite 201
Victorville
CA 92394-1879
Practice Telephone 7602454695
Practice Fax Number 7605134676
Mailing Telephone 7602454695
Mailing Fax Number 7605134676
Enumeration Date 2012-04-24
Last Update Date 2012-04-24
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YM0800X Counselor
Specialization: Mental Health
Behavioral Health & Social Service Providers

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Office Location

Street Address 15095 AMARGOSA RD
SUITE 201
City VICTORVILLE
State CA
Zip Code 92394-1879

Providers in the same location

NPI Name Taxonomy Address Enumeration
1457332884 Mojave Valley Physical Therapy Physical Therapist 15095 Amargosa Rd, Suite 104, Victorville, CA 92394-1879 2005-11-11
1013518547 Syville Talbird Community Health Worker 15095 Amargosa Rd, Victorville, CA 92394-1879 2020-11-02
1780282400 Haynnette Griselda Jimenez Community Health Worker 15095 Amargosa Rd, Victorville, CA 92394-1879 2020-10-14
1053919944 Carmela Santos Case Manager/Care Coordinator 15095 Amargosa Rd, Victorville, CA 92394-1879 2020-10-13
1891393799 Omoyinka Orekoya Community Health Worker 15095 Amargosa Rd, Victorville, CA 92394-1879 2020-10-13
1891312377 Lilliana G Melgar Community Health Worker 15095 Amargosa Rd, Victorville, CA 92394-1879 2020-06-30
1205472438 Elizabeth Difox Case Manager/Care Coordinator 15095 Amargosa Rd, Victorville, CA 92394-1879 2019-11-22
1639728694 Maria L Perez Case Manager/Care Coordinator 15095 Amargosa Rd, Victorville, CA 92394-1879 2019-09-11
1760946560 Myesha Niyoka Alexander Case Manager/Care Coordinator 15095 Amargosa Rd, Victorville, CA 92394-1879 2019-01-25
1265922835 Katherine Nicole Schilling Marriage & Family Therapist 15095 Amargosa Rd, Victorville, CA 92394-1879 2018-05-18
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1164045803 Desert Horizon Residential Care Assisted Living Facility 15952 Condor Rd, Victorville, CA 92394 2020-05-28
1467000943 Tawanna Lasha Young Counselor 15095 Armargosa, Ste 208, Victorville, CA 92394 2019-08-28
1811543473 Silvano Gonzalez Transportation Broker 13767 Hidden Mesa Ct, Victorville, CA 92394 2019-08-09
1215442793 Yun Jung Choi Pharmacist 15318 Roy Rogers Dr., Victorville, CA 92394 2017-12-06
1770942914 Monica Castro Marriage & Family Therapist 15095 Armargosa Rd, 208, Victorville, CA 92394 2016-02-16
1902289226 Daesoon Leem Family Medicine 15095 Amargosa Rd, Bldg.1, #102, Victorville, CA 92394 2015-07-06
1093068322 City Taxi Taxi 14871 Totem Pole St, Victorville, CA 92394 2012-10-24
1467701318 Margarita Renee Ortega Counselor 16224 Tawney Ridge Lane, Victorville, CA 92394 2012-09-06
1326328584 Pro Line Transportation LLC Non-emergency Medical Transport (VAN) 10604 Karen Dr, Victorville, CA 92394 2011-08-19
1164604906 Maxim Healthcare Services, Inc. Home Health 15095 Amargosa Road, Suite 102, Victorville, CA 92394 2007-12-04
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Taxonomy Information

Taxonomy Code 101YM0800X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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1467065789 Jennifer Alejandra Partida Counselor 12650 Sundown Rd, Victorville, CA 92392-7512 2020-08-26
1063078251 Innerpeace Therapy Counselor 15437 Anacapa Rd # 23, Victorville, CA 92392-2458 2019-05-14
1710467659 Harry Lee Jackson Counselor 17845 Ironwood Lane, Victorville, CA 92395-9239 2018-08-20
1114351954 Diane Inez Garcia-becker Counselor 9075 Svl Box, 12905 Rolling Ridge Drive, Victorville, CA 92395-5146 2013-08-28
1720330897 Renae Devolld Counselor 13748 Valera Way, Victorville, CA 92392-6372 2012-10-12
1295083871 Stephanie Denise Williams Counselor 15095 Amargosa Rd. Suite 201, Victorville, CA 92395 2012-08-29
1902153646 Charles Nwufo Counselor 14338 Park Ave Ste 200, Victorville, CA 92392-2925 2012-08-13
1760760797 Jacqueline Rene Bond Counselor 14318 California Ave, Ste. 101, Victorville, CA 92392-2389 2011-07-25
1275783672 Ellen-ruby S. Santos Counselor 15095 Amargosa Rd Ste 201, Victorville, CA 92394-1868 2008-09-23
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Competitor

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City VICTORVILLE
Zip Code 92394

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Dataset Information

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.

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