ROUCHANN ALICIA JACKSON (NPI# 1649893298) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649893298 |
| Entity Type | Individual |
| Full Name | ROUCHANN ALICIA JACKSON |
| Practice Address |
3800 Watt Ave Ste 110 Sacramento CA 95821-2622 |
| Practice Telephone | 2094703105 |
| Enumeration Date | 2020-05-18 |
| Last Update Date | 2020-05-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Street Address |
3800 WATT AVE STE 110 |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95821-2622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275960551 | Brittany Aimee Kelly | Counselor | 3800 Watt Ave Ste 110, Sacramento, CA 95821-2622 | 2013-10-02 |
| 1750995452 | Stacia Marie Wallace | Case Manager/Care Coordinator | 3800 Watt Ave Ste 110, Sacramento, CA 95821-2622 | 2020-09-01 |
| 1508476193 | Corey Lee Moore Jr. | Case Manager/Care Coordinator | 3800 Watt Ave Ste 110, Sacramento, CA 95821-2622 | 2020-08-07 |
| 1205453115 | Nicole Theresa Stiving | Social Worker | 3800 Watt Ave Ste 110, Sacramento, CA 95821-2622 | 2020-06-26 |
| 1093353591 | Amanda Rodrigue-frasier | Student in an Organized Health Care Education/Training Program | 3800 Watt Ave Ste 110, Sacramento, CA 95821-2622 | 2019-12-15 |
| 1932627411 | Katherine Tidrick | Marriage & Family Therapist | 3800 Watt Ave Ste 110, Sacramento, CA 95821-2622 | 2017-09-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972100717 | Denise Renee Landgraf | Licensed Vocational Nurse | 3615 Marconi Ave, Sacramento, CA 95821 | 2020-10-05 |
| 1770053258 | Oksana A Shutkova | Behavior Technician | 2823 El Camino Avenue, Appt #19, Sacramento, CA 95821 | 2018-11-28 |
| 1871063420 | Otto Bock Orthopedic Services LLC | Durable Medical Equipment & Medical Supplies | 3800 Watt Avenue Suite 151, Sacramento, CA 95821 | 2018-11-27 |
| 1386123438 | Rene William Villanueva | Marriage & Family Therapist | 3650 Auburn Blvd Bldg C-208, Sacramento, CA 95821 | 2018-08-09 |
| 1558853135 | Behavioral Health Solutions of The Pacific | Clinic/Center | 2829 Watt Avenue, Suite 200, Sacramento, CA 95821 | 2018-05-31 |
| 1679064091 | Carrissa Jean Angelique Bishop | Counselor | 3550 Watt Avenue, Suite 140, Sacramento, CA 95821 | 2018-05-21 |
| 1164943049 | Vanessa Selene Tinajero | Social Worker | 3615 Macorni Ave, Sacramento, CA 95821 | 2017-06-30 |
| 1316488562 | Lucas Hansen | Student in an Organized Health Care Education/Training Program | 3007 Clairidge Oak Ct, Sacramento, CA 95821 | 2017-03-20 |
| 1215383054 | Mark Brufladt | Physical Therapy Assistant | 3548 Ardmore Rd, Sacramento, CA 95821 | 2016-05-11 |
| 1053782789 | Marianna Jakucska | Marriage & Family Therapist | 2740 Fulton Ave Ste 100c, Sacramento, CA 95821 | 2015-10-07 |
| Find all providers in zip 95821 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952909210 | Christopher Shirey | Counselor | 1618 Alhambra Blvd, Sacramento, CA 95816-7601 | 2020-10-09 |
| 1043824337 | Adonis R Johnson | Counselor | 2500 Marconi Ave, Sacramento, CA 95821-4853 | 2020-09-03 |
| 1528676160 | Hope Lynn Mulligan | Counselor | 2750 Sutterville Rd # Cottage1, Sacramento, CA 95820-1024 | 2020-07-20 |
| 1235756891 | Guneet Kaur | Counselor | 8247 E Stockton Blvd # 4, Sacramento, CA 95828-8200 | 2020-06-30 |
| 1073132635 | Gage Michael Smith | Counselor | 7055 Woodrick Way, Sacramento, CA 95842-2246 | 2020-04-14 |
| 1952935876 | Crystal S Nicholas | Counselor | 845 Fulton Ave Apt 1051, Sacramento, CA 95825-6434 | 2020-02-29 |
| 1255975827 | Molly Ritter | Counselor | 650 Bercut Dr Ste C, Sacramento, CA 95811-0100 | 2019-11-06 |
| 1396393823 | Lannon Hope Gustafson | Counselor | 8573 E Southgate Dr., Sacramento, CA 95823 | 2019-08-28 |
| 1821642265 | Courtney Nelson | Counselor | 7818 Bardu Ln, Sacramento, CA 95829 | 2019-07-24 |
| 1669948212 | Micaela Badue | Counselor | 401 S St., Sacramento, CA 95811 | 2018-10-22 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95821 |
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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.