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

Timothy Wayne Jackson

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1124809363

Timothy Wayne Jackson is an Addiction (Substance Use Disorder) Counselor in Fresno, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2023

Practice location Address checks out

2772 S Martin L King Jr Blvd
Fresno, CA 93706-5345
Phone: (559) 265-4800
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 · Licence 16460 (CA)

Record details

NPI number1124809363
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedOctober 12, 2023
Last updated in NPPESOctober 12, 2023
Certification dateOctober 12, 2023
Mailing address2772 S Martin L King Jr Blvd, Fresno, CA 93706-5345

Other providers in Fresno