Individual
CLIFTON JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15400 CHOLAME RD, VICTORVILLE, CA 92392-2480
(760) 780-4500
Mailing address
15400 CHOLAME RD, VICTORVILLE, CA 92392-2480
(760) 780-4500
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
04/21/2016
Last updated
08/28/2020
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