JACKIE LYNN ANDERSON


Address: 2116 Broadway, Oakland, CA 94612-2310
Phone: (510) 899-4100

JACKIE LYNN ANDERSON (NPI# 1477072437) 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) 1477072437
Entity Type Individual
Full Name JACKIE LYNN ANDERSON
Practice Address 2116 Broadway
Oakland
CA 94612-2310
Practice Telephone (510) 899-4100
Practice Fax Number 5108994110
Mailing Telephone 5108994100
Mailing Fax Number 5108994110
Enumeration Date 2017-09-11
Last Update Date 2017-09-11
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1041C0700X Social Worker
Specialization: Clinical
Behavioral Health & Social Service Providers

Other Providers JACKIE ANDERSON

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1295004406 Jackie Lou Anderson Developmental Therapist 101 Shoreland Rd, Machesney Park, IL 61115-2833 2011-12-16
1447789565 Jackie Mae Anderson Emergency Medicine 10800 Knights Rd, Philadelphia, PA 19114-4200 2017-06-12
1790132652 Jackie Anderson Family Medicine 1010 N Kansas St, Wichita, KS 67214-3124 2016-05-20

Office Location

Street Address 2116 BROADWAY
City OAKLAND
State CA
Zip Code 94612-2310

Providers in the same location

NPI Name Taxonomy Address Enumeration
1609917236 Marsha Vaughn Social Worker 2116 Broadway, Oakland, CA 94612-2310 2007-02-08
1548758287 Courtney B Draper Counselor 2116 Broadway, Oakland, CA 94612-2310 2018-04-27
1679098180 Victor Lavet Nelson Social Worker 2116 Broadway, Oakland, CA 94612-2310 2017-08-04
1982128864 Uganda Knapps Counselor 2116 Broadway, Oakland, CA 94612-2310 2017-08-01
1679007124 Trava Goodwin Social Worker 2116 Broadway, Oakland, CA 94612-2310 2017-04-11
1992254189 Dyesha Gardner Counselor 2116 Broadway, Oakland, CA 94612-2310 2016-09-28
1285012617 Jennifer Spevak Social Worker 2116 Broadway, Oakland, CA 94612-2310 2015-05-18
1518359249 Francisco Rodriguez Bautista Counselor 2116 Broadway, Oakland, CA 94612-2310 2015-03-04
1225442882 Gail Clough Social Worker 2116 Broadway, Oakland, CA 94612-2310 2014-06-11
1962833574 John Safkow Counselor 2116 Broadway, Oakland, CA 94612-2310 2013-12-06
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1437766284 Olivia Vega Behavior Technician 155 Grand Ave Suite 500, Oakland, CA 94612 2020-09-25
1700418001 Thera Share Counselor 1714 Franklin St #411, Oakland, CA 94612 2020-02-05
1386284644 Nicole Yolanda Satterfield Behavioral Analyst 180 Grand, Oakland, CA 94612 2020-01-14
1992365514 Integrative Fertility Acupuncturist 449 15th St, #101, Oakland, CA 94612 2019-06-17
1578029500 Emma Noble Hearing Instrument Specialist 2201 Broadway Ste 328, Oakland, CA 94612 2019-02-14
1992299143 Lutchmia Lizonia Engelbrecht Community Health Worker 160 14th St Apt 501, Oakland, CA 94612 2018-06-20
1417446444 Ruth L Richards Psychiatry & Neurology 475 Fourteenth St, Ninth Floor, Oakland, CA 94612 2018-05-04
1033618384 Thomas Plumber Case Manager/Care Coordinator 1389 Jefferson St Oakland California Apt D210, Oakland, CA 94612 2018-02-01
1992221774 Victoria Davina Casillas Counselor 559 16th Street, Oakland, CA 94612 2017-08-14
1356864854 Mackenzie Sodestrom Marriage & Family Therapist 287 17th St Ste 205, Oakland, CA 94612 2017-07-17
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Taxonomy Information

Taxonomy Code 1041C0700X
Grouping Behavioral Health & Social Service Providers
Classification Social Worker
Specialization Clinical

Taxonomy Definition

A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1265030803 Alana Lyn Kapust Social Worker 590 El Dorado Ave Unit 210, Oakland, CA 94611-5071 2020-10-15
1497377527 Yurianna Hyechong Na Social Worker 1401 Jackson St Apt 501, Oakland, CA 94612-4086 2020-05-12
1861026080 Urban Catalyst Psychotherapy, A Licensed Clinical Social Worker Corpor Social Worker 2700 International Blvd Ste 21, Oakland, CA 94601-1508 2020-02-26
1336789643 Zosime Calame Social Worker 445 Bellevue Ave Ste 300, Oakland, CA 94610-4923 2020-01-14
1316581796 Joaquin Turner Social Worker 2232 Ivy Dr Apt 27, Oakland, CA 94606-1942 2019-10-29
1699324152 Brian Phanichkarn Social Worker 675 Hegenberger Rd Ste 214, Oakland, CA 94621-1989 2019-09-08
1306495007 Winnie Zhi Liao Social Worker 400 Roland Way, Oakland, CA 94621-2012 2019-09-05
1225686314 Victoria Anderson Social Worker 1038 57th St, Oakland, CA 94608-2706 2019-08-31
1881242279 Lauren Martin Social Worker 5231 Market St, Oakland, CA 94608-3254 2019-08-28
1639723703 Joanna La Torre Social Worker 4255 Howe St, Oakland, CA 94611-4704 2019-07-27
Find all providers in OAKLAND

Competitor

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City OAKLAND
Zip Code 94612

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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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