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Organization
LINCOLN
Active
Organization
LINCOLN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE JARELL JACKSON (BEHAVIOR SPECIALIST INTERVENTION)
(650) 646-8563
Entity
Organization
Contact information
Practice address
1266 14TH ST, OAKLAND, CA 94607-2205
(650) 646-8563
Mailing address
34655 SKYLARK DRIVE APT 720, UNION CITY, CA 94587
(650) 646-8563
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
CA
Other
Enumeration date
03/23/2017
Last updated
03/23/2017
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