Individual
VICTORIA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2131 JOHN WOODEN CTR, LOS ANGELES, CA 90095-0001
(310) 206-0621
Mailing address
11958 BAYLA ST, NORWALK, CA 90650-1827
(562) 455-8756
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000050264
CA
Other
Enumeration date
05/31/2022
Last updated
05/31/2022
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