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TANDREYA JACKSON
NPI 1730637125
Rehabilitation Practitioner in Vallejo, CA

Active since September 14, 2016
160 GLEN COVE MARINA RD E STE 102, VALLEJO, CA 94591(707) 648-2000 Get Directions Write a Review

NPPES record last updated: April 3, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 3, 2026, Jun 13, 2023, Sep 14, 2016 (3 updates tracked since 2016).

About Tandreya Jackson NPPES

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

TANDREYA JACKSON (NPI 1730637125) is an individual rehabilitation practitioner in Vallejo, California and active in the NPI registry since September 2016.

NPPES Registry Identity

NPI1730637125
Entity TypeIndividualFemale
Primary Taxonomy225400000X
Provider Legal NameTANDREYA JACKSON
Location Address160 GLEN COVE MARINA RD E STE 102Vallejo, CA 94591-7290
Mailing Address160 Glen Cove Marina Rd E Ste 102Vallejo, CA 94591-7290 · (707) 648-2000
Phone(707) 648-2000
Sole ProprietorNo
Enumeration DateSeptember 14, 2016
Last NPPES UpdateApril 3, 20263 updates tracked since enumeration
NPPES CertifiedApril 3, 2026
✔ NPI 1730637125 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyRehabilitation PractitionerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225400000X
Definition
A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity.
Also ListedCounselorTaxonomy 101Y00000X
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X
160 GLEN COVE MARINA RD E STE 102, Vallejo, CA 94591
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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.

IKE LENARD DAVIS JR.
Counselor (Mental Health)
160 GLEN COVE MARINA RD E STE 102
VALLEJO, CA 94591
Solano County (707) 648-2000
AZRA MIRZA
Community Health Worker
160 GLEN COVE MARINA RD E STE 102
VALLEJO, CA 94591
Solano County (707) 648-2000
MR. PERLESS DANIELS JEFFERSON
Day Training/Habilitation Specialist
160 GLEN COVE MARINA RD E STE 102
VALLEJO, CA 94591
Solano County (707) 648-2000
JERRICA NADINE BENEDIX
Case Manager/Care Coordinator
160 GLEN COVE MARINA RD E STE 102
VALLEJO, CA 94591
Solano County (707) 978-0347
KARINA CAMPOS
Day Training/Habilitation Specialist
160 GLEN COVE MARINA RD E STE 102
VALLEJO, CA 94591
Solano County (510) 910-6904
CHALISS KIRKENDOLL
Rehabilitation Practitioner
160 GLEN COVE MARINA RD E STE 102
VALLEJO, CA 94591
Solano County (707) 648-2000
JAZZMON CRAWFORD
Day Training/Habilitation Specialist
160 GLEN COVE MARINA RD E STE 102
VALLEJO, CA 94591
Solano County (707) 648-2000
SEDALIA EVANS
Day Training/Habilitation Specialist
160 GLEN COVE MARINA RD E STE 102
VALLEJO, CA 94591
Solano County (707) 648-2000

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 Tandreya Jackson's NPI number?

The NPI number for Tandreya Jackson is 1730637125. It was assigned to this individual provider in the NPPES registry on September 14, 2016.

Where is Tandreya Jackson located?

Tandreya Jackson practices at 160 Glen Cove Marina Rd E Ste 102, Vallejo, CA 94591. The listed phone number is (707) 648-2000.

What is Tandreya Jackson's specialty?

The primary specialty registered for this NPI is Rehabilitation Practitioner with taxonomy code 225400000X.

When was this NPI record last updated?

The NPPES record for Tandreya Jackson was last updated on April 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.