Jackson, Shelby

Jackson, Shelby is an individual health care provider with primary practice located at 4870 Sadler Rd Suite #300, Glen Allen VA 23060-6294. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavior Technician, Behavioral Health & Social Service Providers / Behavioral Analyst. Behavioral Health & Social Service Providers / Behavioral Analyst is her primary health care specialty. Jackson, Shelby can be contacted via phone (916) 479-4328.

Contact Information

Primary practice address
4870 Sadler Rd Suite #300 Glen Allen VA 23060-6294
Phone: (916) 479-4328
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X California

Profile Details

NPI number 1891267910
LBN Legal business name Jackson, Shelby
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 31st, 2018
Last updated May 26th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891267910 NPPES
California MEDICAID 68-0396223

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