Individual
DALE JACKNOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
101 S SAN MATEO DR, SUITE 208, SAN MATEO, CA 94401-3819
(650) 342-3137
Mailing address
101 S SAN MATEO DR, SUITE 208, SAN MATEO, CA 94401-3819
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
657898
CA
Other
Enumeration date
05/13/2009
Last updated
05/13/2009
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