Jessica Jackson

NPI 1083972681 - Marriage & Family Therapist - 106H00000X

NPI Details
NPI 1083972681
Gender Female
Enumeration Date 05/02/2012
Last Updated 03/11/2013
Entity Type Individual
Active Over 4 years ago
Practice Location
130 YELLOWSTONE DR
SUITE 110
CHICO CA, 95973-5884, US
Phone (530) 879-5991
Fax
Business Location
1565 N CHERRY ST
APT. 47
CHICO CA, 95926-3770, US
Phone (530) 774-3646
Fax
Toxanomy
Taxonomy Code 106H00000X
License State California
License Number 74276
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According to our database, Ms. Jessica Jackson NPI is 1083972681, taxonomy code is 106H00000X and license number is 74276, license state is located at California. Jessica Jackson physically located at 130 Yellowstone Dr, Chico CA, 95973-5884. NPI Number Jessica Jackson has the Individual type.

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1083972681 NPI number is provided on an as is basis without warranty of any kind. 1083972681 is maintained by the National Plan & Provider Enumeration System. The contents of Jessica Jackson are for informational purposes only.