KATHRYN JACKSON (NPI# 1295160091) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295160091 |
| Entity Type | Individual |
| Full Name | KATHRYN JACKSON |
| Credential | CADC-II |
| Practice Address |
12125 Shale Ridge Ln Auburn CA 95602-8880 |
| Practice Telephone | 5308851917 |
| Mailing Telephone | 5308851917 |
| Enumeration Date | 2013-09-11 |
| Last Update Date | 2019-12-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
A051990218 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710478144 | Kathryn Jackson | Social Worker | 18331 Wolfpack Way, Hagerstown, MD 21740-3583 | 2018-05-22 |
| 1609048735 | Kathryn Martin Jackson | Speech-Language Pathologist | 1879 E Robinson Ave, Springdale, AR 72764-5713 | 2008-03-28 |
| 1780661694 | Kathryn Jackson | Registered Nurse | 6002 Westgate Blvd Ste 274, Tacoma, WA 98406-2571 | 2005-12-30 |
| 1528053816 | Kathryn Horton Jackson | Pharmacist | 5445 Meridian Marks Rd Ne, Suite 190, Atlanta, GA 30342-4763 | 2005-09-13 |
| 1649888314 | Kathryn Jackson | Speech-Language Pathologist | 7281 W Charleston Blvd, Las Vegas, NV 89117-1592 | 2020-07-20 |
| 1659936607 | Kathryn Marie Jackson | Social Worker | 2670 Durham Chapel Hill Blvd, Durham, NC 27707-2829 | 2019-05-06 |
| 1558829861 | Kathryn Jackson | Behavioral Analyst | 500 Ala Moana Blvd Ste 7400, Honolulu, HI 96813-4902 | 2019-03-05 |
| 1942707914 | Kathryn Elizabeth Jackson | Occupational Therapist | 905 Arrowhead Trl, Warner Robins, GA 31088-5390 | 2018-04-06 |
| 1447632922 | Kathryn Miles Jackson | Audiologist | 1505 Sw Cary Pkwy, Suite 301, Cary, NC 27511-6219 | 2015-06-22 |
| 1093157919 | Kathryn Lynelle-tudor Jackson | Case Manager/Care Coordinator | 201 W Springdale Ave, Knoxville, TN 37917-5158 | 2013-07-19 |
| Street Address |
12125 SHALE RIDGE LN |
| City | AUBURN |
| State | CA |
| Zip Code | 95602-8880 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518184621 | Granite Wellness Centers | Substance Abuse Rehabilitation Facility | 12125 Shale Ridge Ln, Auburn, CA 95602-8880 | 2007-04-19 |
| 1508463134 | Tyann J Stebbins | Counselor | 12125 Shale Ridge Ln, Auburn, CA 95602-8880 | 2020-10-06 |
| 1457962557 | Greyson C Guzman | Counselor | 12125 Shale Ridge Ln, Auburn, CA 95602-8880 | 2020-08-12 |
| 1669095865 | Marques P Whitfield | Counselor | 12125 Shale Ridge Ln, Auburn, CA 95602-8880 | 2020-05-21 |
| 1639706930 | Jennifer L Kittelman | Counselor | 12125 Shale Ridge Ln, Auburn, CA 95602-8880 | 2020-03-25 |
| 1821629544 | Liana A Elliott | Counselor | 12125 Shale Ridge Ln, Auburn, CA 95602-8880 | 2020-01-31 |
| 1356988513 | Jessica Mont-eton | Counselor | 12125 Shale Ridge Ln, Auburn, CA 95602-8880 | 2019-12-06 |
| 1720621402 | Jillian G Ramos | Counselor | 12125 Shale Ridge Ln, Auburn, CA 95602-8880 | 2019-10-24 |
| 1497309009 | Erika A Morrow | Counselor | 12125 Shale Ridge Ln, Auburn, CA 95602-8880 | 2019-07-31 |
| 1982261558 | Danny L Johnson | Counselor | 12125 Shale Ridge Ln, Auburn, CA 95602-8880 | 2019-05-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144770793 | Western Sierra Medical Clinic, Inc. | Clinic/Center | 12183 Locksley Ln Ste 107, Auburn, CA 95602 | 2016-10-06 |
| 1073904231 | Bunny Stanfield | Psychologist | 6435 Fairway Ct., Auburn, CA 95602 | 2015-02-10 |
| 1326319419 | Blake Reed Williams | Counselor | 10593 Rockview Ct, Auburn, CA 95602 | 2012-01-20 |
| 1548387970 | Richard Earl Thornton | Chiropractor | 10988 Combie Road, Suite 100, Auburn, CA 95602 | 2007-03-22 |
| 1346378957 | Stanford K Schulte | Marriage & Family Therapist | 3215 Fortune Court, Auburn, CA 95602 | 2007-03-02 |
| 1144372590 | Daniel E Mertz Dds Inc | Dentist | 3205 Professional Dr, Auburn, CA 95602 | 2007-01-17 |
| 1619035805 | Robert Lee Hook | General Practice | 11775 Education St Ste 211, Auburn, CA 95602 | 2006-12-04 |
| 1568536191 | Sierra Foothills Surgical Specialists Inc | Surgery | 3257 Professional Drive, Suite E, Auburn, CA 95602 | 2006-11-17 |
| 1093898710 | David Ray Norcott | Optometrist | 3211 Fortune Court, Auburn, CA 95602 | 2006-10-24 |
| 1467553834 | Heather Lynne Perry | Chiropractor | 3275 Fortune Ct, Auburn, CA 95602 | 2006-09-26 |
| Find all providers in zip 95602 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164044715 | James Raymond Watts | Counselor | 31624 117th Ave Se, Auburn, WA 98092-3697 | 2020-05-16 |
| 1992344329 | Jessica Megan Basaldua | Counselor | 178 Gamage Ave Apt 1, Auburn, ME 04210-4573 | 2020-01-02 |
| 1104397314 | Chanda Denise Allen | Counselor | 721 45th St Ne, Auburn, WA 98002-1303 | 2018-12-16 |
| 1447733746 | Theodore Parfet | Counselor | 12183 Locksley Ln # 101102, Auburn, CA 95602-2004 | 2018-09-12 |
| 1033612742 | Jeffery M Ostrom | Counselor | 12183 Locksley Ln Ste 201, Auburn, CA 95602-2052 | 2018-03-09 |
| 1972010650 | Mountain Side Behavioral Health | Counselor | 70 College Way, Auburn, CA 95603-5001 | 2018-01-04 |
| 1962864421 | Yesenia Estrada | Counselor | 11837 Kemper Rd Ste 2, Auburn, CA 95603-9067 | 2016-03-24 |
| 1235507419 | Debra Rossi | Counselor | 12183 Locksley Ln Ste 103, Auburn, CA 95602-2050 | 2015-09-04 |
| 1023417136 | Canaan Sampson | Counselor | 11837 Kemper Rd, Auburn, CA 95603-9067 | 2014-08-14 |
| 1053754416 | Alex E Broady | Counselor | 17300 Se 392nd Street, Auburn, WA 98092 | 2013-04-16 |
| Find all providers in AUBURN | ||||
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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.