Individual ProviderEdward JacksonCounselorBehavioral Health & Social Service ProvidersPractice Address3007 Telegraph Ave, Oakland, CA 94609-3205(510) 433-1500PECOS EnrollmentBased on the most recent information from CMS, provider Edward Jackson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1083816326Provider TypeIndividualFull NameJackson, EdwardTitleMr.GenderMaleSole ProprietorNoEnumeration Date5/31/2007Last Updated7/8/2007Contact InformationPractice LocationPractice Address3007 Telegraph Ave, Oakland, CA 94609-3205Phone(510) 433-1500Fax(510) 433-1526Mailing LocationMailing Address3007 Telegraph Ave, Oakland, CA 94609-3205Phone(510) 433-1500Fax(510) 433-1526Provider TaxonomiesCodeDescriptionLicenseCode101YA0400XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer