npidata.org Sign in
Products
Provider RadarWatch an area and specialty — weekly alerts on new cliniciansPractice RadarWeekly alerts when new organisations register nearbySpecialtiesEvery NUCC taxonomy, with counts by state and cityStatesProvider counts and breakdowns for all 50 statesPhysician listsMDs and DOs with addresses and phone numbersNP listsNurse practitioners, the fastest-growing groupAPIJSON, delta feed, free tier
Use cases
Healthcare sales prospectingPhysician recruiting and locum staffingMedical device sales territory planningCredentialing and provider verificationHealthcare marketing lists and audience buildingPharmaceutical sales and prescriber targeting
Account
Start freeThree radars and an export a month Sign in Pricing
Explore
Data Labs API
About
About usTermsPrivacyContact us

Search › California › Addiction (Substance Use Disorder) Counselor

Governor Jackson

NPI 1124297692 · on the registry since 2008 · sole proprietor

Practice

Address
1235 Mchenry Ave Ste A&B
Modesto, CA 95350
Phone
(209) 527-4597
Organisation at this address
Aegis Treatment Centers, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
126

Registry record

Primary taxonomy
Addiction (Substance Use Disorder) Counselor
101YA0400X
Sex
Male
Record last updated
2026-06-28
Status
Not present in the most recent federal file

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California