Provider Demographics
NPI:1174727416
Name:JACKSON, URANA KARA (MFTI)
Entity type:Individual
Prefix:
First Name:URANA
Middle Name:KARA
Last Name:JACKSON
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:765 RAND AVE APT 400
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-2210
Mailing Address - Country:US
Mailing Address - Phone:510-384-9799
Mailing Address - Fax:
Practice Address - Street 1:765 RAND AVE APT 400
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94610-2210
Practice Address - Country:US
Practice Address - Phone:510-384-9799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52588106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist