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STACIE JACKSON
NPI 1073292306
Counselor - Addiction (Substance Use Disorder) in Pomona, CA

Active since July 13, 2023
831 E ARROW HWY, POMONA, CA 91767(909) 398-4383 Get Directions Write a Review

NPPES record last updated: April 18, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 18, 2024, Jul 13, 2023 (2 updates tracked since 2023).

About Stacie Jackson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STACIE JACKSON (NPI 1073292306) is an individual addiction (substance use disorder) provider in Pomona, California, licensed in California (R1494190123) and active in the NPI registry since July 2023.

NPPES Registry Identity

NPI1073292306
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameSTACIE JACKSON
Location Address831 E ARROW HWYPomona, CA 91767-2535
Mailing Address831 E Arrow HwyPomona, CA 91767-2535 · (909) 398-4383
Phone(909) 398-4383
Sole ProprietorNo
Enumeration DateJuly 13, 2023
Last NPPES UpdateApril 18, 20242 updates tracked since enumeration
NPPES CertifiedApril 18, 2024
✔ NPI 1073292306 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in CA · R1494190123
831 E ARROW HWY, Pomona, CA 91767
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LIZBETH DIAZ ACSW
Social Worker
831 E ARROW HWY
POMONA, CA 91767
Los Angeles County (909) 624-1233
PROTOTYPES CENTERS FOR INNOVATION IN HEALTH, MENTAL HEALTH AND SOCIAL
Community/Behavioral Health
831 E ARROW HWY
POMONA, CA 91767
Los Angeles County (909) 398-4383
ASILI MAISHA WILBOURN LVN
Licensed Vocational Nurse
831 E ARROW HWY
POMONA, CA 91767
Los Angeles County (909) 398-4383
MAYTE MURILLO
Case Manager/Care Coordinator
831 E ARROW HWY
POMONA, CA 91767
Los Angeles County (909) 398-4383
KELLI HUMPHREYS
Day Training/Habilitation Specialist
831 E ARROW HWY
POMONA, CA 91767
Los Angeles County (909) 398-4383
BRITTNEY LEE LCSW
Social Worker (Clinical)
831 E ARROW HWY
POMONA, CA 91767
Los Angeles County (909) 398-4383
ELVIA VILLALOBOS RADT
Counselor (Addiction (Substance Use Disorder))
831 E ARROW HWY
POMONA, CA 91767
Los Angeles County (909) 624-1233
JAIMIE BJUR
Student in an Organized Health Care Education/Training Program
831 E ARROW HWY
POMONA, CA 91767
Los Angeles County (909) 398-4383

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stacie Jackson's NPI number?

The NPI number for Stacie Jackson is 1073292306. It was assigned to this individual provider in the NPPES registry on July 13, 2023.

Where is Stacie Jackson located?

Stacie Jackson practices at 831 E Arrow Hwy, Pomona, CA 91767. The listed phone number is (909) 398-4383.

What is Stacie Jackson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Stacie Jackson was last updated on April 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.