Provider Demographics
NPI:1518441773
Name:JACKSON, DARCY ANN (MA, LMFT)
Entity type:Individual
Prefix:
First Name:DARCY
Middle Name:ANN
Last Name:JACKSON
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:DARCY
Other - Middle Name:ANN
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2918 ALBATROSS WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95815
Mailing Address - Country:US
Mailing Address - Phone:707-631-3353
Mailing Address - Fax:
Practice Address - Street 1:2918 ALBATROSS WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815
Practice Address - Country:US
Practice Address - Phone:707-631-3353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-23
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA106H00000XMedicaid