Look up the most recent NPI and PECOS records

Yvette Jackson

Counselor

Behavioral Health & Social Service Providers

380 W Macarthur Blvd, Oakland, CA 94609-2819

PECOS Enrollment

Based on the most recent information from CMS, provider Yvette Jackson is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1366809774
Provider Type
Individual
Full Name
Jackson, Yvette
Credential
MS,CAP,ICADC,CADCII

Gender
Female
Sole Proprietor
No
Enumeration Date
1/15/2016
Last Updated
3/16/2023

Contact Information

Practice Location

380 W Macarthur Blvd, Oakland, CA 94609-2819

(925) 450-1306

Unlisted Fax

Mailing Location

380 W Macarthur Blvd, Oakland, CA 94609-2819

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YA0400X Primary	Description Counselor Behavioral Health & Social Service Providers	License RA08190915 California

Yvette Jackson

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Vitali, Sean

Lent, Nikole Rosanna

Edmond, Marjorie Silverse

Stokes, Naima Marie

Page, Jerricka

Pruett Kotowski, Ashley

Slaughter, Gerald J

Camacho, Jeanette

Lewis, Rodney

Valencia, Christina Maria