Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kevin Jackson Sr.

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1164845400

Kevin Jackson Sr. is an Addiction (Substance Use Disorder) Counselor in San Bernardino, California. Registered with an NPI since 2014.

In the registry since
2014

Practice location Address checks out

621 E Carnagie Dr # 210 San Bernardino CA 92415
San Bernardino, CA 92415-3919
Phone: (909) 386-9767
Fax: (909) 381-2172
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X

Record details

NPI number1164845400
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 22, 2014
Last updated in NPPESJanuary 14, 2020
Certification dateJanuary 14, 2020

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