Individual provider · Type 1 NPI

Samantha L. Jackson

Mental Health Counselor · Emeryville, CA

NPI number 1174906549 Active

Practice location

1335 Stanford Ave
Emeryville, CA 94608-2536

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1174906549

Samantha L. Jackson's National Provider Identifier is 1174906549, issued on Jul 3, 2015. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Emeryville, CA. The record was last updated on Apr 11, 2025.