Individual
CARRIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3252 HOLIDAY CT STE 107, LA JOLLA, CA 92037-1807
(803) 206-1550
Mailing address
3252 HOLIDAY CT STE 107, LA JOLLA, CA 92037-1807
(803) 206-1550
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
32824
CA
Other
Enumeration date
07/01/2019
Last updated
07/12/2023
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