Individual
DINA A. JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
900 MAIN ST, BRAWLEY, CA 92227-2630
(559) 213-0297
Mailing address
2037 W BULLARD AVE, #135, FRESNO, CA 93711-1200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA11863
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PA11863
—
CA
Enumeration date
06/22/2006
Last updated
02/11/2025
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