Individual
BRYAN JACKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
44421 10TH ST W, LANCASTER, CA 93534-3335
(818) 996-1051
Mailing address
18646 OXNARD ST, TARZANA, CA 91356-1411
(818) 996-1051
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/24/2024
Last updated
01/24/2024
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