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Individual

COURTNEY JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1302 N 4TH ST, SAN JOSE, CA 95112-4713
(408) 379-3790
Mailing address
1302 N 4TH ST, SAN JOSE, CA 95112-4713
(408) 379-3790

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-29055
CA

Other

Enumeration date
10/25/2017
Last updated
04/24/2024
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