Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
GOVERNOR GILFORD JACKSON
Active Sole ProprietorGOVERNOR GILFORD JACKSON is a Addiction (Substance Use Disorder) Counselor healthcare provider located in MODESTO, California. NPI 1124297692 is currently active in the NPPES registry. Verify at CMS.
Addiction (Substance Use Disorder) Counselor · MODESTO, CA
Registration Details
- NPI Number
- 1124297692
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 28, 2008 (18.477302846929 yrs)
- Last Updated
- Oct 5, 2021
- Sole Proprietor
- Yes
Practice Information
- Address
-
1235 MCHENRY AVE STE A&BMODESTO, CA, 953505370Browse CA providers · Browse ZIP 95350
- Phone
- 2095274597
- Primary Specialty
-
Addiction (Substance Use Disorder) Counselor
101YA0400X
Other Addiction (Substance Use Disorder) Counselor Providers in MODESTO, CA
| Name | Credential | NPI |
|---|---|---|
| LEANNA KRISTEN CARROTT | — | 1144371295 |
| TANYA KRISTINE BAESA-SEVILLANO | — | 1942351887 |
| DEE SORENSEN | — | 1255482311 |
| MISS PATRICIA E PALMERIN | — | 1720139876 |
| DAVID PETERSON | — | 1851443469 |
| LUTRICIA DAVANNA MILTON | — | 1538204342 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.