Individual
CARNELL JACKSON II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2918 W VERNON AVE, LOS ANGELES, CA 90008-4757
(323) 497-8150
(323) 292-5543
Mailing address
2918 W VERNON AVE, LOS ANGELES, CA 90008-4757
(323) 497-8150
(323) 292-5543
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/24/2007
Last updated
10/24/2007
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