KYLE LAMET JACKSON
NPI 1275018384
Marriage & Family Therapist in Fairfield, CA

Q: What is Kyle Jackson's NPI number?

The NPI number for Kyle Jackson is 1275018384. It was assigned to this individual provider in the NPPES registry on September 25, 2018.

Q: What is Kyle Jackson's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Q: When was this NPI record last updated?

The NPPES record for Kyle Jackson was last updated on December 30, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since September 25, 2018PECOS EnrolledAccepts Medicare Assignment

744 EMPIRE ST, FAIRFIELD, CA 94533(925) 768-5052 Get Directions Write a Review

NPPES record last updated: December 30, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 30, 2021, Sep 25, 2018 (2 updates tracked since 2018).

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About Kyle Lamet Jackson NPPES

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

KYLE LAMET JACKSON (NPI 1275018384) is an individual marriage & family therapist in Fairfield, California, licensed in California (88118) and active in the NPI registry since September 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2015).

NPPES Registry Identity

NPI1275018384

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameKYLE LAMET JACKSON

Location Address744 EMPIRE STFairfield, CA 94533-5562

Mailing Address744 Empire StFairfield, CA 94533-5562 · (925) 768-5052

Phone(925) 768-5052

Sole ProprietorNo

Medical School CMSOtherGraduated 2015

Enumeration DateSeptember 25, 2018

Last NPPES UpdateDecember 30, 20212 updates tracked since enumeration

✔ NPI 1275018384 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

License✔ Licensed in CA · 88118

Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

744 EMPIRE ST, Fairfield, CA 94533

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kyle Lamet Jackson is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3274970769

PECOS Enrollment IDI20240319004189

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 18

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

KENT HIROSHI HIGA I

Community Health Worker