Individual
COURTNEY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
975 SERENO DR, VALLEJO, CA 94589-2441
(707) 651-1318
Mailing address
1908 SOLANO AVE, VALLEJO, CA 94590-6446
(916) 420-3403
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
38295
CA
Other
Enumeration date
02/21/2019
Last updated
02/21/2019
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