Individual
CHANEL D JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1355 S HILL ST, LOS ANGELES, CA 90015-3012
(213) 389-5820
Mailing address
550 S VERMONT AVE RM 904, LOS ANGELES, CA 90020-1912
(213) 738-4775
(213) 632-5892
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/15/2019
Last updated
05/15/2019
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