TRAVIS J JACKSON - NPI 1093063257 - Counselor in San Francisco, CA

Q: What is Travis Jackson's NPI number?

The NPI number for Travis Jackson is 1093063257. It was assigned to this individual provider in the NPPES registry on August 20, 2012.

Q: What is Travis Jackson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Travis Jackson was last updated on August 20, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Travis J Jackson NPPES

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

TRAVIS J JACKSON (NPI 1093063257) is an individual mental health provider in San Francisco, California and active in the NPI registry since August 2012.

NPPES Registry Identity

NPI1093063257

Entity TypeIndividualMale

Primary Taxonomy101YM0800X

Provider Legal NameTRAVIS J JACKSON

Location Address1550 TREAT AVESan Francisco, CA 94110-5234

Mailing Address1550 Treat AveSan Francisco, CA 94110-5234 · (415) 641-8000 · Fax (415) 641-8002

Phone(415) 641-8000

Fax(415) 641-8002

Sole ProprietorNo

Enumeration DateAugust 20, 2012

✔ NPI 1093063257 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

1550 TREAT AVE, San Francisco, CA 94110

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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.

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