MR. SCOTT A JACKSON CADC II NPI 1902278690

NPI Information

  • NPI: 1902278690
  • Provider Name: MR. SCOTT A JACKSON, CADC II
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Individual
  • Address: 3148 MIDWAY DR # 113
    SAN DIEGO, CA
    ZIP 92110
  • Phone: (619) 619-3630

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NPI Details

MR. Scott A Jackson, CADC II is an addiction (substance use disorder) counselor in San Diego, CA. MR. Scott A Jackson, CADC II NPI is 1902278690. 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:

3148 MIDWAY DR # 113
SAN DIEGO, CA
ZIP 92110-539
Phone: (619) 619-3630
Fax: (619) 362-9905

The enumeration date for this NPI number is 10/21/2015 and was last updated on 5/21/2024.

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
1171M00000XCase Manager/Care CoordinatorCI4400615CALIFORNIANo
2101YA0400XCounselorAddiction (Substance Use Disorder)A040000816CALIFORNIAYes

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: 3/30/2025

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