Individual
TELIAH JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1333 WILLOW PASS RD STE 110, CONCORD, CA 94520-5225
(925) 676-7431
Mailing address
275 E 12TH ST APT 301, OAKLAND, CA 94606-2246
(510) 338-8268
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
54746
CA
Other
Enumeration date
05/25/2021
Last updated
05/25/2021
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