Samantha Jackson
NPI 1174906549 · Mental Health Counselor · Emeryville, CA
Enrolled with Medicare as Practitioner - Clinical Psychologist · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Samantha Jackson is a Mental Health Counselor provider in Emeryville, CA (NPI 1174906549).
Provider details
- NPI number
- 1174906549
- Entity type
- Individual
- Primary specialty
- Mental Health CounselorBehavioral Health & Social Service Providers
- Sex
- Female
- Sole proprietor
- No
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2015-07-03
- Last updated
- 2025-04-11
- Certified
- 2025-04-11
Frequently asked questions
- What is Samantha Jackson's NPI number?
- Samantha Jackson's National Provider Identifier (NPI) is 1174906549, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Samantha Jackson's specialty?
- Samantha Jackson is listed in the NPPES registry with a primary specialty of Mental Health Counselor (Behavioral Health & Social Service Providers).
- Where is Samantha Jackson located?
- Samantha Jackson's practice location on file with NPPES is 1335 Stanford Ave, Emeryville, CA 94608-2536.
- What is Samantha Jackson's phone number?
- The practice phone number listed in the NPPES registry for Samantha Jackson is (510) 647-5101.
- Does Samantha Jackson accept Medicare?
- Samantha Jackson is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Samantha Jackson's NPI active?
- Yes — Samantha Jackson's NPI (1174906549) is active in the NPPES registry as of the last update on 2025-04-11.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.