RUDY JACKSON NPI 1881144152

NPI Information

NPI: 1881144152
Provider Name: RUDY JACKSON
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
5738 W FREMONT AVE
FRESNO, CA
ZIP 93722
Phone: (559) 375-3040
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Rudy Jackson is a mental health counselor in Fresno, CA. Rudy Jackson NPI is 1881144152. 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:

5738 W FREMONT AVE
FRESNO, CA
ZIP 93722-044
Phone: (559) 375-3040

The enumeration date for this NPI number is 10/10/2016 and was last updated on 10/10/2016.

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)		CALIFORNIA	No
2	101YM0800X	Counselor	Mental Health		CALIFORNIA	Yes

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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