Provider Demographics
NPI:1629955315
Name:JACKSON-BURNS, CYNTHIA KAY
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:KAY
Last Name:JACKSON-BURNS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8080 HANSOM DR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605-4209
Mailing Address - Country:US
Mailing Address - Phone:510-866-9287
Mailing Address - Fax:
Practice Address - Street 1:2181 TICE VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94595-2505
Practice Address - Country:US
Practice Address - Phone:510-866-9287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-16
Last Update Date:2025-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health