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Individual
KAREN ANN JACKA
Active
Individual
KAREN ANN JACKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCS16470
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3810106
PROVIDER # AETNA
CA
01
—
48809
PRIVIDER NUMBER MHN
CA
01
—
62-79934
PROV. NO.UNITED HEALTH CA
CA
01
—
A881670
VALUE OPITIONS VENDOR NUM
CA
Enumeration date
04/10/2007
Last updated
08/27/2018
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