MR. TRACEY L JACKSON
NPI 1558486803
Counselor in Sacramento, CA

Active since March 19, 2007
4612 ROOSEVELT AVE, SACRAMENTO, CA 95820(916) 457-3129 Get Directions Write a Review

NPPES record last updated: January 11, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mr. Tracey L Jackson NPPES

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

MR. TRACEY L JACKSON (NPI 1558486803) is an individual counselor in Sacramento, California and active in the NPI registry since March 2007. He maintains a secondary practice location in Sacramento.

NPPES Registry Identity

NPI1558486803
Entity TypeIndividualMale
Primary Taxonomy101Y00000X
Provider Legal NameMR. TRACEY L JACKSON
Location Address4612 ROOSEVELT AVESacramento, CA 95820
Mailing Address4612 Roosevelt AveSacramento, CA 95820-4520 · (916) 457-3129
Sole ProprietorNo
Enumeration DateMarch 19, 2007
Last NPPES UpdateJanuary 11, 2019
NPI 1558486803 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

4612 ROOSEVELT AVE, Sacramento, CA 95820

Secondary Practice Location 1

Location 17000 Franklin Blvd Ste 200Sacramento, CA 95823-1865 · Phone (916) 394-0800 ext. 75 · Fax (916) 429-7824

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.

Licensed Psychiatric Technician
4612 ROOSEVELT AVE
SACRAMENTO, CA 95820
Social Worker (Clinical)
4612 ROOSEVELT AVE
SACRAMENTO, CA 95820
Community Health Worker
4612 ROOSEVELT AVE
SACRAMENTO, CA 95820
Licensed Vocational Nurse
4612 ROOSEVELT AVE
SACRAMENTO, CA 95820
Licensed Psychiatric Technician
4612 ROOSEVELT AVE
SACRAMENTO, CA 95820
Technician, Pathology (Phlebotomy)
4612 ROOSEVELT AVE
SACRAMENTO, CA 95820
Licensed Psychiatric Technician
4612 ROOSEVELT AVE
SACRAMENTO, CA 95820
Student in an Organized Health Care Education/Training Program
4612 ROOSEVELT AVE
SACRAMENTO, CA 95820

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 Tracey Jackson's NPI number?

The NPI number for Tracey Jackson is 1558486803. It was assigned to this individual provider in the NPPES registry on March 19, 2007.

Where is Tracey Jackson located?

Tracey Jackson practices at 4612 Roosevelt Ave, Sacramento, CA 95820. The listed phone number is (916) 457-3129.

What is Tracey Jackson's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

When was this NPI record last updated?

The NPPES record for Tracey Jackson was last updated on January 11, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.