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MR. SCOTT A JACKSON CADC II
NPI 1902278690
Counselor - Addiction (Substance Use Disorder) in San Diego, CA

Active since October 21, 2015
3148 MIDWAY DR # 113, SAN DIEGO, CA 92110(619) 619-3630(619) 362-9905 Get Directions Write a Review

NPPES record last updated: April 17, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. Scott A Jackson Cadc Ii NPPES

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

MR. SCOTT A JACKSON CADC II (NPI 1902278690) is an individual addiction (substance use disorder) provider in San Diego, California, licensed in California (A040000816) and active in the NPI registry since October 2015.

NPPES Registry Identity

NPI1902278690
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameMR. SCOTT A JACKSONCredential: CADC II
Location Address3148 MIDWAY DR # 113San Diego, CA 92110-4539
Mailing Address3148 Midway Dr # 113San Diego, CA 92110-4539 · (619) 619-3630 · Fax (619) 362-9905
Phone(619) 619-3630
Fax(619) 362-9905
Sole ProprietorYes
Enumeration DateOctober 21, 2015
Last NPPES UpdateApril 17, 2025
NPPES CertifiedApril 17, 2025
✔ NPI 1902278690 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in CA · A040000816
Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X · License CI4400615 (CA)
3148 MIDWAY DR # 113, San Diego, CA 92110
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Other Providers at the Same Location NPPES 2

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

SAMANTHA JEAN ANTHONY RAD1
Counselor
3148 MIDWAY DR # 113
SAN DIEGO, CA 92110
San Diego County (619) 363-0853
LAURA DENISE VICTORIA
Specialist/Technologist, Health Information
3148 MIDWAY DR # 113
SAN DIEGO, CA 92110
San Diego County (619) 363-0853

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 Scott Jackson's NPI number?

The NPI number for Scott Jackson is 1902278690. It was assigned to this individual provider in the NPPES registry on October 21, 2015.

Where is Scott Jackson located?

Scott Jackson practices at 3148 Midway Dr # 113, San Diego, CA 92110. The listed phone number is (619) 619-3630.

What is Scott Jackson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Scott Jackson was last updated on April 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.