1. Home
  2. Directory
  3. California
  4. Stockton
  5. Marriage Family Therapist
  6. NPI Profile

PHANNONG JACKSON MFTI
NPI 1447474382
Marriage & Family Therapist in Stockton, CA

Active since April 12, 2007
1212 N CALIFORNIA ST, STOCKTON, CA 95202(209) 468-8700 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Phannong Jackson Mfti NPPES

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

PHANNONG JACKSON MFTI (NPI 1447474382) is an individual marriage & family therapist in Stockton, California, licensed in California (IMF41435) and active in the NPI registry since April 2007.

NPPES Registry Identity

NPI1447474382
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NamePHANNONG JACKSONCredential: MFTI
Location Address1212 N CALIFORNIA STStockton, CA 95202-1552
Mailing Address1212 N California StStockton, CA 95202-1552 · (209) 468-8700
Phone(209) 468-8700
Sole ProprietorNo
Enumeration DateApril 12, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1447474382 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 · IMF41435
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.
1212 N CALIFORNIA ST, Stockton, CA 95202
Open in Google Maps ↗

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.

SAN JOAQUIN COUNTY BEHAVIORAL HEALTH SERVICES
Clinic/Center (Mental Health (Including Community Mental Health Center))
1212 N CALIFORNIA ST
STOCKTON, CA 95202
San Joaquin County (209) 468-8700
PENNY GIBBONS BURKE RPH
Pharmacist
1212 N CALIFORNIA ST
STOCKTON, CA 95202
San Joaquin County (209) 468-8711
DOLORIS MOODY
Case Manager/Care Coordinator
1212 N CALIFORNIA ST
STOCKTON, CA 95202
San Joaquin County (209) 468-8660
MS. DELIA ORDAZ RN
Registered Nurse
1212 N CALIFORNIA ST
STOCKTON, CA 95202
San Joaquin County (209) 468-3760
DONNA L BICKHAM ACSW
Social Worker (Clinical)
1212 N CALIFORNIA ST
STOCKTON, CA 95202
San Joaquin County (209) 953-7313
RITA N. MENDOZA
Technician, Other
1212 N CALIFORNIA ST
STOCKTON, CA 95202
San Joaquin County (209) 468-8718
MR. KENNETH RAY COCIO
Counselor (Mental Health)
1212 N CALIFORNIA ST
STOCKTON, CA 95202
San Joaquin County (209) 468-8660
ANDREA MICHELLE HERNANDEZ
Counselor (Mental Health)
1212 N CALIFORNIA ST
STOCKTON, CA 95202
San Joaquin County (209) 468-8686

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 Phannong Jackson's NPI number?

The NPI number for Phannong Jackson is 1447474382. It was assigned to this individual provider in the NPPES registry on April 12, 2007.

Where is Phannong Jackson located?

Phannong Jackson practices at 1212 N California St, Stockton, CA 95202. The listed phone number is (209) 468-8700.

What is Phannong Jackson's specialty?

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

When was this NPI record last updated?

The NPPES record for Phannong Jackson was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.