SHIRLEY JACKSON (NPI# 1790343507) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790343507 |
| Entity Type | Individual |
| Full Name | SHIRLEY JACKSON |
| Practice Address |
245 11th St San Francisco CA 94103-3732 |
| Practice Telephone | 4153746487 |
| Mailing Telephone | 4153746487 |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2019-06-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073915559 | Shirley Jackson | Occupational Therapy Assistant | 170 Village Court, Martinsville, VA 24112 | 2014-09-16 |
| 1538218292 | Shirley Jean Jackson | Registered Nurse | 21 North Atwood Ave, Janesville, WI 53648 | 2007-01-10 |
| 1558806687 | Shirley Jackson | Substance Abuse Rehabilitation Facility | 2151 Rush Blvd, Youngstown, OH 44507-1535 | 2016-12-28 |
| 1144689936 | Shirley Jackson | Licensed Vocational Nurse | 9808 Venice Blvd, Ste. 505, Culver City, CA 90232-2732 | 2016-02-22 |
| 1982943486 | Shirley Jackson | Registered Nurse | 7600 Geogia Ave, Suite 323, Washington, DC 20012 | 2013-02-05 |
| 1396926499 | Shirley Jackson | Counselor | 3625 14th St, Riverside, CA 92501-3815 | 2007-11-16 |
| 1407947484 | Shirley A Jackson | Counselor | 1400 Vfw Pkwy, West Roxbury, MA 02132-4927 | 2006-09-27 |
| Street Address |
245 11TH ST |
| City | SAN FRANCISCO |
| State | CA |
| Zip Code | 94103-3732 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508974791 | Melissa Anne Jethanandani | Nurse Practitioner | 245 11th St, San Francisco, CA 94103 | 2006-08-28 |
| 1609473735 | Ethan Huffman | Nurse Practitioner | 245 11th St, San Francisco, CA 94103-3732 | 2020-10-01 |
| 1700492212 | Janice K Yu | Marriage & Family Therapist | 245 11th St, San Francisco, CA 94103-3732 | 2020-09-21 |
| 1629699137 | Joel Estrellado | Licensed Psychiatric Technician | 245 11th St, San Francisco, CA 94103-3732 | 2020-05-06 |
| 1942834692 | Azizi Shautay Gupton | Marriage & Family Therapist | 245 11th St, San Francisco, CA 94103-3732 | 2020-03-02 |
| 1649818295 | Marquita Thomas | Community Health Worker | 245 11th St, San Francisco, CA 94103-3732 | 2019-12-13 |
| 1467094383 | Roshawn Mathews | Licensed Vocational Nurse | 245 11th St, San Francisco, CA 94103-3732 | 2019-10-11 |
| 1215595012 | Chenice A Jackson | Counselor | 245 11th St, San Francisco, CA 94103-3732 | 2019-06-05 |
| 1215498670 | Tiffany M Andrade | Community Health Worker | 245 11th St, San Francisco, CA 94103-3732 | 2019-03-28 |
| 1548720576 | Tam Nguyen | Community Health Worker | 245 11th St, San Francisco, CA 94103-3732 | 2019-03-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669015665 | Cheng Chi Chang | Student in an Organized Health Care Education/Training Program | 987 Mission Street, San Francisco, CA 94103 | 2019-10-22 |
| 1366925604 | Sharon Farrell | Specialist | Citywide Forensics, 982 Mission Street, San Francisco, CA 94103 | 2018-09-12 |
| 1548748759 | Muvr Labs, Inc | Clinic/Center | 724 Bannan Street, San Francisco, CA 94103 | 2018-07-31 |
| 1245727585 | Marco Alejandro Regalado Chacon | Counselor | 1035 Market St Ste 100, San Francisco, CA 94103 | 2018-04-20 |
| 1679091854 | Maia Elizabeth Anello | Counselor | 42 Mclea Ct., San Francisco, CA 94103 | 2017-09-07 |
| 1710405584 | Wendy Siuping Leung | Specialist | 1380 Howard Street, Second Floor, 201b, San Francisco, CA 94103 | 2017-08-31 |
| 1740707397 | Leslie My Ngoc Lam | Specialist | 1380 Howard Street., 3rd Floor, San Francisco, CA 94103 | 2017-08-24 |
| 1598281990 | Raymundo Macias | Counselor | 1563 Mission Street, San Francisco, CA 94103 | 2017-08-17 |
| 1720502461 | Kathie Isabel Cordova | Specialist | 1380 Howard Streeet, San Francisco, CA 94103 | 2017-08-02 |
| 1154850428 | Elizabeth Osterwald | Counselor | 150 9th Street, San Francisco, CA 94103 | 2017-06-08 |
| Find all providers in zip 94103 | ||||
| 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 |
|---|---|---|---|---|
| 1972104628 | Ann Egan | Counselor | 207 Cole St, San Francisco, CA 94117-1915 | 2020-11-07 |
| 1326654518 | Mina Dailami | Counselor | 45 Adair St Apt A, San Francisco, CA 94103-3699 | 2020-09-22 |
| 1538773841 | Samantha Santamaria | Counselor | 1001 Potrero Ave Rm 7g12, San Francisco, CA 94110-3518 | 2020-09-03 |
| 1659980076 | Claire Katherine Sheeran | Counselor | 1275 34th Ave, San Francisco, CA 94122-1306 | 2020-07-31 |
| 1104434331 | Archana Chatkara Thomas | Counselor | 974 Pine St Apt 9, San Francisco, CA 94108-2928 | 2020-07-14 |
| 1790306157 | Katherine Rose Kaffka | Counselor | 995 Potrero Ave # 220, San Francisco, CA 94110-2859 | 2020-04-27 |
| 1265073811 | Matthew Charles Paden | Counselor | 1801 Vicente St San Francisco, San Francisco, CA 94116-2923 | 2019-10-04 |
| 1801442140 | Danielle Sawicki | Counselor | 4355 Geary Blvd, San Francisco, CA 94118-3003 | 2019-08-13 |
| 1417501347 | Kimberly Shadean Wedderburn | Counselor | 2200 Hayes St Fl 3, San Francisco, CA 94117-1013 | 2019-07-29 |
| 1740847250 | Caroline Elson | Counselor | 1440 Steiner St Apt 3, San Francisco, CA 94115-4128 | 2019-05-21 |
| Find all providers in SAN FRANCISCO | ||||
| City | SAN FRANCISCO |
| Zip Code | 94103 |
Please comment or provide details below to improve the information on SHIRLEY JACKSON.
| 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.