Individual
AEISHA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3075 MYERS ST, RIVERSIDE, CA 92503-5525
(951) 358-4625
Mailing address
20463 VALLEY BLVD, WALNUT, CA 91789-2729
(909) 594-2762
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
Primary
90846
CA
Other
Enumeration date
02/15/2016
Last updated
04/28/2025
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