TANANNA RAYLYNN JACKSON NPI 1578432522

NPI Information

  • NPI: 1578432522
  • Provider Name: TANANNA RAYLYNN JACKSON
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Individual
  • Address: 2550 W CLINTON AVE UNIT 311
    FRESNO, CA
    ZIP 93705
  • Phone: (559) 365-9665

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NPI Details

Tananna Raylynn Jackson is an addiction (substance use disorder) counselor in Fresno, CA. Tananna Raylynn Jackson NPI is 1578432522. 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:

2550 W CLINTON AVE UNIT 311
FRESNO, CA
ZIP 93705-218
Phone: (559) 365-9665

The enumeration date for this NPI number is 10/29/2025 and was last updated on 10/29/2025.

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)17666CALIFORNIAYes

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

NPI Synchronization or Removal

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