ROGER M JACKSON
NPI 1265015861
Counselor - Mental Health in Modesto, CA
About Roger M Jackson NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ROGER M JACKSON (NPI 1265015861) is an individual mental health provider in Modesto, California and active in the NPI registry since April 2021.
NPPES Registry Identity
Specialties & Licenses
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 Roger Jackson's NPI number?
The NPI number for Roger Jackson is 1265015861. It was assigned to this individual provider in the NPPES registry on April 30, 2021.
Where is Roger Jackson located?
Roger Jackson practices at 225 El Vista Ave, Modesto, CA 95354. The listed phone number is (918) 400-9718.
What is Roger Jackson's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
When was this NPI record last updated?
The NPPES record for Roger Jackson was last updated on April 30, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Roger M Jackson · NPI 1265015861
Mental Health provider in Modesto, California. Individual provider, active in the CMS NPPES registry since April 30, 2021.
## Identity
- **NPI:** 1265015861 (Entity type: Individual)
- **Enumerated:** April 30, 2021
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 225 EL VISTA AVE, Modesto, CA 95354-3007
- **Phone:** (918) 400-9718
## Record status
- **NPPES last updated:** April 30, 2021
---
Source: [NPI Profile](https://npiprofile.com/npi/1265015861) · Data from the CMS NPPES public registry.