# SHADY CREEK THERAPY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Teri Jackson
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710543483
- **Authorized official:** TERI L JACKSON LMFT109393 (MARRIAGE FAMILY THERAPIST)
- **Authorized official phone:** (530) 713-8266

## Contact information

- **Practice address:** 289 MAIN ST \#6, CHESTER, CA 96020-9602
- **Practice address phone:** (530) 713-8266
- **Mailing address:** PO BOX 673, CHESTER, CA 96020-0673
- **Mailing address phone:** (530) 713-8266

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 05/17/2019
- **Last updated:** 05/17/2019