Individual
CHARENCE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5805 SEPULVEDA BLVD, SHERMAN OAKS, CA 91411-2546
(818) 980-3200
Mailing address
5805 SEPULVEDA BLVD, SHERMAN OAKS, CA 91411-2546
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Enumeration date
01/08/2024
Last updated
05/12/2025
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