RONALD WAYNE JACKSON RADT NPI 1922647346

NPI Information

NPI: 1922647346
Provider Name: RONALD WAYNE JACKSON, RADT
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
939 N D ST
SAN BERNARDINO, CA
ZIP 92410
Phone: (909) 889-6519
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Ronald Wayne Jackson, RADT is an addiction (substance use disorder) counselor in San Bernardino, CA. Ronald Wayne Jackson, RADT NPI is 1922647346. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

939 N D ST
SAN BERNARDINO, CA
ZIP 92410-519
Phone: (909) 889-6519

The enumeration date for this NPI number is 1/2/2020 and was last updated on 2/22/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	R1367361019	CALIFORNIA	Yes
2	405300000X	Prevention Professional		RADT78265	CALIFORNIA	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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