Individual provider · Type 1 NPI
Shanee Domonique Jackson
Substance Abuse Rehabilitation Facility · Stockton, CA
NPI number
1255262887
Active
Practice location
819 E Hammer Ln Apt 139
Stockton, CA 95210-2751
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 25707 |
| Substance Abuse Rehabilitation Facility Primary | 324500000X | None listed |
Substance Abuse Rehabilitation Facility: A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
Other substance abuse rehabilitation facility providers in Stockton
About NPI 1255262887
Shanee Domonique Jackson's National Provider Identifier is 1255262887, issued on May 25, 2026. The primary taxonomy on file is Substance Abuse Rehabilitation Facility (324500000X), and the practice location is in Stockton, CA. The record was last updated on May 25, 2026.