Phoenix Jackson
NPI 1619349933 · Mental Health Counselor · San Rafael, CA
Phoenix Jackson is a Mental Health Counselor provider in San Rafael, CA (NPI 1619349933).
Provider details
- NPI number
- 1619349933
- Entity type
- Individual
- Primary specialty
- Mental Health CounselorBehavioral Health & Social Service Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 91873 (CA)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
- Counselor101Y00000X
Behavioral Health & Social Service Providers
- School Counselor101YS0200X
Behavioral Health & Social Service Providers
Student, Health Care
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
100% 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
- 2015-10-26
- Last updated
- 2016-10-25
Frequently asked questions
- What is Phoenix Jackson's NPI number?
- Phoenix Jackson's National Provider Identifier (NPI) is 1619349933, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Phoenix Jackson's specialty?
- Phoenix Jackson is listed in the NPPES registry with a primary specialty of Mental Health Counselor (Behavioral Health & Social Service Providers).
- Where is Phoenix Jackson located?
- Phoenix Jackson's practice location on file with NPPES is 1 Saint Vincents Dr, San Rafael, CA 94903-1504.
- What is Phoenix Jackson's phone number?
- The practice phone number listed in the NPPES registry for Phoenix Jackson is (415) 610-1768.
- Is Phoenix Jackson's NPI active?
- Yes — Phoenix Jackson's NPI (1619349933) is active in the NPPES registry as of the last update on 2016-10-25.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.