JACKSON ROACH
NPI 1992368104
Counselor - Mental Health in San Jose, CA

Q: What is Jackson Roach's NPI number?

The NPI number for Jackson Roach is 1992368104. It was assigned to this individual provider in the NPPES registry on April 15, 2019.

Q: What is Jackson Roach's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Jackson Roach was last updated on April 15, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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 April 15, 2019

452 S 1ST ST, SAN JOSE, CA 95113(408) 841-4319(408) 286-3855 Get Directions Write a Review

NPPES record last updated: April 15, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Jackson Roach NPPES

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

JACKSON ROACH (NPI 1992368104) is an individual mental health provider in San Jose, California and active in the NPI registry since April 2019.

NPPES Registry Identity

NPI1992368104

Entity TypeIndividualMale

Primary Taxonomy101YM0800X

Provider Legal NameJACKSON ROACH

Location Address452 S 1ST STSan Jose, CA 95113-2815

Mailing AddressPo Box 127Napa, CA 94559-0127 · (707) 255-3300 · Fax (707) 255-3527

Phone(408) 841-4319

Fax(408) 286-3855

Sole ProprietorNo

Enumeration DateApril 15, 2019

✔ NPI 1992368104 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

452 S 1ST ST, San Jose, CA 95113

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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.

DIANA HERNANDEZ

Counselor (Mental Health)

452 S 1ST ST
SAN JOSE, CA 95113

Santa Clara County (408) 292-9353

DOMINIQUE ROSS

Counselor (Mental Health)

452 S 1ST ST
SAN JOSE, CA 95113

Santa Clara County (408) 343-7940

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 Jackson Roach's NPI number?

The NPI number for Jackson Roach is 1992368104. It was assigned to this individual provider in the NPPES registry on April 15, 2019.

Where is Jackson Roach located?

Jackson Roach practices at 452 S 1st St, San Jose, CA 95113. The listed phone number is (408) 841-4319.

What is Jackson Roach's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Jackson Roach was last updated on April 15, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.