Individual
MS. ARTENESHA L JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, ASW
Contact information
Practice address
2607 MYRTLE ST, OAKLAND, CA 94607-3415
(510) 835-1393
Mailing address
747 52ND ST, OAKLAND, CA 94609-1809
(510) 428-3000
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003961251
NONE
CA
Enumeration date
08/23/2007
Last updated
08/28/2014
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