Selena Jackson in Lakeport - Addiction (substance Use Disorder)
Selena Jackson - NPI 1386810208
Selena Jackson is a Addiction (substance Use Disorder) in Lakeport, California. Selena Jackson practices all healthcare services and medical treatments related to Addiction (substance Use Disorder). The NPI Number for Selena Jackson is 1386810208. The last update date is 2017-05-02.
Selena Jackson's current location address is 390 N Forbes St, Lakeport, California. You can contact this provider via phone number 7079945486. The mailing address for Selena Jackson is 390 N Forbes St, Lakeport, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Selena Jackson |
|---|---|
| Address | 390 N Forbes St, Lakeport, California |
| Phone Number | 7079945486 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | BREININGIN |
NPI Number Detail
| NPI Number | 1386810208 |
|---|---|
| Provider Enumeration Date | 2008-04-30 |
| Last Updated Date | 2017-05-02 |
Provider Mailing Address Detail
| Address | 390 N Forbes St |
|---|---|
| City | Lakeport |
| State | California (CA) |
| Post Code | 954534724 |
| Phone Number | 7079945486 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Addiction (substance Use Disorder) |
|---|---|
| Taxonomy | 101Ya0400X |
| Licence No | RI-J08030918 |
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Definition: A counselor who helps people with alcohol, drug, gambling, internet, and other types of addictions. |
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What is the unique 10-digit identification code assigned to Selena Jackson by the Centers for Medicare & Medicaid Services?
The Selena Jackson has been issued the NPI (National Provider Identifier) 1386810208, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Selena Jackson's physical address?
The Selena Jackson is physically located at 390 N Forbes St, in the city of Lakeport, CA, with the postal code 954534724.
What is Selena Jackson's specialized field of practice, and what is the corresponding taxonomy classification code?
The Selena Jackson's area of specialization is Addiction (substance Use Disorder), and the corresponding taxonomy code that categorizes this field of practice is 101Ya0400X.
On what date did the Selena Jackson receive the assignment of its 1386810208 from the Centers for Medicare & Medicaid Services?
The Selena Jackson was issued its 1386810208 by the Centers for Medicare & Medicaid Services on 2008-04-30.
When was the information regarding Selena Jackson most recently updated?
The details pertaining to the Selena Jackson, including its address, specialty, and other relevant information, were last refreshed on 2017-05-02.