GARY JACKSON (NPI# 1447473772) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447473772 |
| Entity Type | Individual |
| Full Name | GARY JACKSON |
| Practice Address |
1756 S Lewis Rd Camarillo CA 93012-8520 |
| Mailing Address |
45 Sulphur Mountain Rd Ventura CA 93001-1007 |
| Practice Telephone | 8053833669 |
| Mailing Telephone | 8054513285 |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033462932 | Gary D Jackson | Counselor | 4610 Santa Anita Blvd, Suite D, El Monte, CA 91731 | 2012-10-17 |
| 1720317688 | Gary Howard Jackson | Orthopaedic Surgery | 38 Bent Pebble Pt, Lumberton, MS 39455-9037 | 2009-12-23 |
| 1578692331 | Gary L. Jackson | Internal Medicine | Lincoln County Medical Center, 211 Sudderth, Ruidoso, NM 88345 | 2007-03-05 |
| 1447237839 | Gary Lee Jackson | Chiropractor | 20595 Sw Tv Hwy #102, Ste 102, Aloha, OR 97006 | 2005-12-27 |
| 1609426022 | Gary Dean Jackson | Pharmacist | 11340 Three Rivers Rd Ste A, Gulfport, MS 39503-3650 | 2019-09-17 |
| 1992119838 | Gary Chase Jackson | Optometrist | 6030 W University Blvd, Odessa, TX 79764 | 2014-06-18 |
| 1154528263 | Gary Wayne Jackson | Physician Assistant | 1804 College Ave, Levelland, TX 79336-6507 | 2007-07-02 |
| 1700884947 | Gary L Jackson | Nurse Anesthetist, Certified Registered | 4100 Summerhill Rd, Texarkana, TX 75503-2732 | 2005-07-12 |
| Street Address |
1756 S LEWIS RD |
| City | CAMARILLO |
| State | CA |
| Zip Code | 93012-8520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609925577 | Dianna Oliver | Specialist | 1756 S Lewis Rd, Camarillo, CA 93012-8520 | 2007-01-09 |
| 1457978124 | Wendy Pamela Cruz Villatoro | Counselor | 1756 S Lewis Rd, Camarillo, CA 93012-8520 | 2020-06-29 |
| 1639796394 | Carmelo Israel Lopez | Counselor | 1756 S Lewis Rd, Camarillo, CA 93012-8520 | 2020-06-29 |
| 1295352961 | April Del Rosario | Counselor | 1756 S Lewis Rd, Camarillo, CA 93012-8520 | 2020-06-29 |
| 1285251959 | Michelle White | Counselor | 1756 S Lewis Rd, Camarillo, CA 93012-8520 | 2020-06-29 |
| 1063039741 | Juanita Ruiz | Counselor | 1756 S Lewis Rd, Camarillo, CA 93012-8520 | 2020-06-29 |
| 1104443860 | Beverly Donate | Counselor | 1756 S Lewis Rd, Camarillo, CA 93012-8520 | 2020-06-29 |
| 1871118877 | Stefania Hernandez Martinez | Case Manager/Care Coordinator | 1756 S Lewis Rd, Camarillo, CA 93012-8520 | 2020-06-15 |
| 1902377682 | David Alexander Ramos | Counselor | 1756 S Lewis Rd, Camarillo, CA 93012-8520 | 2018-12-06 |
| 1871077677 | Lauren Sansone | Counselor | 1756 S Lewis Rd, Camarillo, CA 93012-8520 | 2018-09-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992322895 | Natasha Nichole Johnson | Licensed Vocational Nurse | 1750 A S Lewis Rs, Camarillo, CA 93012 | 2020-06-26 |
| 1609392604 | Dain Emmanuel Acevedo | Counselor | 5284 Adolfo Road Suite 100, Camarillo, CA 93012 | 2017-08-21 |
| 1679093751 | Emily Sophia Rodriguez | Counselor | 5284 Adolfo Rd. Suite 100, Camarillo, CA 93012 | 2017-06-21 |
| 1164952750 | Valerie Marie Inez Rivera | Counselor | 5284 Adolfo Rd #100, Camarillo, CA 93012 | 2017-06-15 |
| 1457890709 | Constance Walsh | Prosthetic/Orthotic Supplier | 795 Camarillo Springs Rd, Suite C, Carmarillo, CA 93012 | 2017-02-20 |
| 1902349020 | Ferdinand Fortune Cuico | Registered Nurse | 421 Brister Park Ct, Camarillo, CA 93012 | 2016-11-21 |
| 1699226795 | Lauren Streiter | Counselor | 1750b S Lewis Rd, Camarillo, CA 93012 | 2016-10-24 |
| 1972955649 | Evolve Growth Initiatives, LLC | Community Based Residential Treatment Facility, Mental Illness | 799 Camarillo Springs Road, Ventura, CA 93012 | 2016-07-06 |
| 1083075089 | Justin Rodriguez Urbano | Dental Hygienist | 4422 Corte Arbusto, Camarillo, CA 93012 | 2016-03-18 |
| 1578924619 | Leslie Winn | Counselor | 291 Camino Leon, Camarillo, CA 93012 | 2016-03-17 |
| Find all providers in zip 93012 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184239394 | Desiree Butler | Counselor | 975 Flynn Rd # 8704, Camarillo, CA 93012-8704 | 2020-09-14 |
| 1023573284 | Anthony Omar Thompson | Counselor | 954 Gracia St, Camarillo, CA 93010-3940 | 2019-02-01 |
| 1073081741 | Tyler Briann Aliano-kirksey | Counselor | 2009 Las Estrellas Ct, Camarillo, CA 93012-4070 | 2018-11-11 |
| 1174098651 | Tatianna Kraft | Counselor | 4243 Vincente Ave, Camarillo, CA 93010 | 2018-10-10 |
| 1750860730 | Gina P. Martinez | Counselor | 5284 Adolfo Rd # Sweet100, Camarillo, CA 93012-6787 | 2018-08-09 |
| 1942794326 | Raymundo Cervantes | Counselor | 153 Ripley St, Camarillo, CA 93010-2617 | 2018-06-19 |
| 1609392604 | Dain Emmanuel Acevedo | Counselor | 5284 Adolfo Road Suite 100, Camarillo, CA 93012 | 2017-08-21 |
| 1679093751 | Emily Sophia Rodriguez | Counselor | 5284 Adolfo Rd. Suite 100, Camarillo, CA 93012 | 2017-06-21 |
| 1164952750 | Valerie Marie Inez Rivera | Counselor | 5284 Adolfo Rd #100, Camarillo, CA 93012 | 2017-06-15 |
| 1326574211 | Sintya Liseth Herrera Rodriguez | Counselor | 5284 Adolfo Rd Ste 200, Camarillo, CA 93012-6788 | 2017-05-11 |
| Find all providers in CAMARILLO | ||||
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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.