LYNETTE JACKSON NPI 1154288256

NPI Information

  • NPI: 1154288256
  • Provider Name: LYNETTE JACKSON
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • Address: 2200 STANDIFORD AVE APT 126
    MODESTO, CA
    ZIP 95350
  • Phone: (209) 569-3351

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NPI Details

Lynette Jackson is a mental health counselor in Modesto, CA. Lynette Jackson NPI is 1154288256. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2200 STANDIFORD AVE APT 126
MODESTO, CA
ZIP 95350-540
Phone: (209) 569-3351
Fax: (209) 290-3587

The enumeration date for this NPI number is 1/8/2026 and was last updated on 1/8/2026.

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
1101YA0400XCounselorAddiction (Substance Use Disorder)202030210947CALIFORNIANo
2171400000XHealth and Wellness Coach202030210947CALIFORNIANo
3171W00000XContractor202030210947CALIFORNIANo
4171M00000XCase Manager/Care Coordinator202030210947CALIFORNIANo
5174H00000XHealth Educator202030210947CALIFORNIANo
6251E00000XHome Health202030210947CALIFORNIANo
7175L00000XHomeopath202030210947CALIFORNIANo
8251300000XLocal Education Agency (LEA)202030210947CALIFORNIANo
9320600000XResidential Treatment Facility, Intellectual and/or Developmental Disabilities202030210947CALIFORNIANo
10251B00000XCase Management202030210947CALIFORNIANo
11101YM0800XCounselorMental Health202030210947CALIFORNIAYes

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: 11/21/2025

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