Individual
BAHATI JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7501 INTERNATIONAL BLVD, OAKLAND, CA 94621-2843
(510) 729-8800
(510) 569-4965
Mailing address
7501 INTERNATIONAL BLVD, OAKLAND, CA 94621-2843
(510) 729-8800
(510) 569-4965
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/28/2016
Last updated
10/28/2016
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