Individual provider · Type 1 NPI

Roger M. Jackson

Mental Health Counselor · Modesto, CA

NPI number 1265015861 Active

Practice location

225 El Vista Ave
Modesto, CA 95354-3007

Call (918) 400-9718 Map

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1265015861

Roger M. Jackson's National Provider Identifier is 1265015861, issued on Apr 30, 2021. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Modesto, CA. The record was last updated on Apr 30, 2021.