# ACTION JACKSON PHYSICAL THERAPY, P.C.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255700555
- **Authorized official:** MR. SHANE LORAN JACKSON DPT (OWNER/PHYSICAL THERAPIST)
- **Authorized official phone:** (510) 292-5385

## Contact information

- **Practice address:** 2844 SUMMIT ST, SUITE 106, OAKLAND, CA 94609-3637
- **Practice address phone:** (510) 763-3005
- **Mailing address:** 1005 SOLANO AVE, APT. A, ALBANY, CA 94706-1617
- **Mailing address phone:** (510) 292-5385

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | PT23897 | CA | Yes |

## Other

- **Enumeration date:** 09/17/2015
- **Last updated:** 09/17/2015