Individual
CHRISTOPHER LUKE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
2177 N BROWER ST, SIMI VALLEY, CA 93065-2447
(818) 939-9058
Mailing address
2177 N BROWER ST, SIMI VALLEY, CA 93065-2447
(818) 939-9058
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
432815
CA
Other
Enumeration date
06/18/2019
Last updated
06/18/2019
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