# LINCOLN

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

## Provider details

- **NPI number:** 1346771169
- **Authorized official:** JAMIE JARELL JACKSON (BEHAVIOR SPECIALIST INTERVENTION)
- **Authorized official phone:** (650) 646-8563

## Contact information

- **Practice address:** 1266 14TH ST, OAKLAND, CA 94607-2205
- **Practice address phone:** (650) 646-8563
- **Mailing address:** 34655 SKYLARK DRIVE APT 720, UNION CITY, CA 94587
- **Mailing address phone:** (650) 646-8563

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | CA | Yes |

## Other

- **Enumeration date:** 03/23/2017
- **Last updated:** 03/23/2017