Individual
IMAGINE ELEGE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
268 LEWELLING BLVD, ASHLAND, CA 94580-1632
(510) 514-8642
Mailing address
268 LEWELLING BLVD, ASHLAND, CA 94580-1632
(510) 514-8642
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
01278978
CA
Other
Enumeration date
02/13/2026
Last updated
02/13/2026
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