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GOVERNOR GILFORD JACKSON
NPI 1124297692
Counselor - Addiction (Substance Use Disorder) in Modesto, CA

Active since February 28, 2008
1235 MCHENRY AVE STE A&B, MODESTO, CA 95350(209) 527-4597 Get Directions Write a Review

NPPES record last updated: June 28, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Governor Gilford Jackson NPPES

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

GOVERNOR GILFORD JACKSON (NPI 1124297692) is an individual addiction (substance use disorder) provider in Modesto, California and active in the NPI registry since February 2008.

NPPES Registry Identity

NPI1124297692
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameGOVERNOR GILFORD JACKSON
Location Address1235 MCHENRY AVE STE A&BModesto, CA 95350-5370
Mailing Address1235 Mchenry Ave Ste A&bModesto, CA 95350-5370 · (209) 527-4597
Phone(209) 527-4597
Sole ProprietorYes
Enumeration DateFebruary 28, 2008
Last NPPES UpdateJune 28, 2026
NPPES CertifiedSeptember 22, 2021
✔ NPI 1124297692 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
1235 MCHENRY AVE STE A&B, Modesto, CA 95350
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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.

ANDREW MENDONCA
Counselor (Addiction (Substance Use Disorder))
1235 MCHENRY AVE STE A&B
MODESTO, CA 95350
Stanislaus County (209) 527-4597
SERENITY NICOLE SULEK
Counselor (Addiction (Substance Use Disorder))
1235 MCHENRY AVE STE A&B
MODESTO, CA 95350
Stanislaus County (209) 527-4597
MS. ELIZABETH JAZMIN FIGUEROA
Counselor (Addiction (Substance Use Disorder))
1235 MCHENRY AVE STE A&B
MODESTO, CA 95350
Stanislaus County (209) 527-4597
ASHLEY BORUM
Counselor (Addiction (Substance Use Disorder))
1235 MCHENRY AVE STE A&B
MODESTO, CA 95350
Stanislaus County (209) 527-4597
SARAH ELIZABETH SERRANO
Counselor (Addiction (Substance Use Disorder))
1235 MCHENRY AVE STE A&B
MODESTO, CA 95350
Stanislaus County (209) 527-4597
ANGELA PANGILINAN
Licensed Vocational Nurse
1235 MCHENRY AVE STE A&B
MODESTO, CA 95350
Stanislaus County (209) 527-4597
KARA FRENCH LVN
Licensed Vocational Nurse
1235 MCHENRY AVE STE A&B
MODESTO, CA 95350
Stanislaus County (209) 527-4597
CHUEMEE MOUA
Counselor (Addiction (Substance Use Disorder))
1235 MCHENRY AVE STE A&B
MODESTO, CA 95350
Stanislaus County (209) 527-4597

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 Governor Jackson's NPI number?

The NPI number for Governor Jackson is 1124297692. It was assigned to this individual provider in the NPPES registry on February 28, 2008.

Where is Governor Jackson located?

Governor Jackson practices at 1235 Mchenry Ave Ste A&b, Modesto, CA 95350. The listed phone number is (209) 527-4597.

What is Governor 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 Governor Jackson was last updated on June 28, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.