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Search › California › 101YM0800X

Lynette Jackson

NPI 1154288256 · on the registry since 2026 · sole proprietor

Practice

Address
2200 Standiford Ave Apt 126
Modesto, CA 95350
Phone
(209) 569-3351
Fax
(209) 290-3587
Clinicians at this address
2

Registry record

Primary taxonomy
101YM0800X
101YM0800X
Also registered as
101YA0400X
171400000X
171W00000X
171M00000X
174H00000X
251E00000X
175L00000X
251300000X
320600000X
251B00000X
Licence states on file
CA
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2026-02-10

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