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TIMOTHY WAYNE JACKSON
NPI 1124809363
Counselor - Addiction (Substance Use Disorder) in Fresno, CA

Active since October 12, 2023
2772 S MARTIN L KING JR BLVD, FRESNO, CA 93706(559) 265-4800 Get Directions Write a Review

NPPES record last updated: October 12, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Timothy Wayne Jackson NPPES

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

TIMOTHY WAYNE JACKSON (NPI 1124809363) is an individual addiction (substance use disorder) provider in Fresno, California, licensed in California (16460) and active in the NPI registry since October 2023.

NPPES Registry Identity

NPI1124809363
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameTIMOTHY WAYNE JACKSON
Location Address2772 S MARTIN L KING JR BLVDFresno, CA 93706-5345
Mailing Address2772 S Martin L King Jr BlvdFresno, CA 93706-5345 · (559) 265-4800
Phone(559) 265-4800
Sole ProprietorYes
Enumeration DateOctober 12, 2023
NPPES CertifiedOctober 12, 2023
✔ NPI 1124809363 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 · 16460
2772 S MARTIN L KING JR BLVD, Fresno, CA 93706
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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.

ADEL S HUSSEIN
Counselor (Addiction (Substance Use Disorder))
2772 S MARTIN L KING JR BLVD
FRESNO, CA 93706
Fresno County (559) 265-4800
MICHELLE JAMIA STONE SUDCC IV CS
Counselor (Addiction (Substance Use Disorder))
2772 S MARTIN L KING JR BLVD
FRESNO, CA 93706
Fresno County (559) 265-4800
LISA MONIQUE HARRIS
Counselor (Addiction (Substance Use Disorder))
2772 S MARTIN L KING JR BLVD
FRESNO, CA 93706
Fresno County (559) 265-4800
NICOLE HINOJOSA
Counselor (Addiction (Substance Use Disorder))
2772 S MARTIN L KING JR BLVD
FRESNO, CA 93706
Fresno County (559) 251-4800
JUSTIN FRANCISCO LARA CADCIII:B00004030425
Counselor (Addiction (Substance Use Disorder))
2772 S MARTIN L KING JR BLVD
FRESNO, CA 93706
Fresno County (559) 265-4800
ANITA VEGA
Counselor (Addiction (Substance Use Disorder))
2772 S MARTIN L KING JR BLVD
FRESNO, CA 93706
Fresno County (559) 265-4800
ELIZABETH GAMA-SANCHEZ APCC
Counselor (Professional)
2772 S MARTIN L KING JR BLVD
FRESNO, CA 93706
Fresno County (559) 265-4800
ANDREA L HOU
Counselor (Addiction (Substance Use Disorder))
2772 S MARTIN L KING JR BLVD
FRESNO, CA 93706
Fresno County (559) 265-4800

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 Timothy Jackson's NPI number?

The NPI number for Timothy Jackson is 1124809363. It was assigned to this individual provider in the NPPES registry on October 12, 2023.

Where is Timothy Jackson located?

Timothy Jackson practices at 2772 S Martin L King Jr Blvd, Fresno, CA 93706. The listed phone number is (559) 265-4800.

What is Timothy 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 Timothy Jackson was last updated on October 12, 2023. 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.