Dr. Nicole S Jackson, Ph.D.
Psychologist in Sacramento, CA. Individual provider (NPI-1).
NPI number1508288762
StatusActive
Last updated in NPPESAug 8, 2024
Details
- NPI
- 1508288762
- Entity type
- Individual (NPI-1)
- Name
- Dr. Nicole S Jackson
- Credential
- Ph.D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 7, 2014
- Certification date
- Aug 8, 2024
- Last updated
- Aug 8, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103T00000X | Psychologist | – | – | Yes |
| 103TA0400X | Psychologist, Addiction (Substance Use Disorder) | – | – | |
| 172V00000X | Community Health Worker | – | – |
Practice location
7001a East PkwySacramento, CA 95823-2501
Phone 916-873-0976
Mailing address
9146 E Stockton Blvd Unit 1070Elk Grove, CA 95624-9510
Phone 916-873-0976
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