Individual
ERICA R JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11355 DESMOND ST, GARDEN GROVE, CA 92841
(228) 357-0974
Mailing address
11355 DESMOND ST, GARDEN GROVE, CA 92841
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
08/16/2019
Last updated
08/16/2019
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