Individual
DOLORES JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1445 E. TAM O'SHANTER STREET, ONTARIO, CA 91761-7117
(951) 205-2789
(909) 673-0409
Mailing address
1445 E. TAM O'SHANTER STREET, ONTARIO, CA 91761-7117
(951) 205-2789
(909) 673-0409
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
77534
CA
374U00000X
Home Health Aide
Primary
77534
CA
Other
Enumeration date
09/14/2010
Last updated
09/14/2010
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