Organization
BROOKE P JACKSON PSYCHOLOGIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BROOKE P JACKSON PSYD (OWNER)
(415) 609-2361
Entity
Organization
Contact information
Practice address
1044 SIR FRANCIS DRAKE BLVD STE 1, KENTFIELD, CA 94904-1454
(415) 609-2361
Mailing address
1044 SIR FRANCIS DRAKE BLVD STE 1, KENTFIELD, CA 94904-1454
(415) 609-2361
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
07/17/2020
Last updated
07/17/2020
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