Individual
CHARLESTON R JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5655 LINDERO CANYON RD STE 302, WESTLAKE VILLAGE, CA 91362-4045
(818) 997-6876
Mailing address
8031 SEPULVEDA BLVD APT 33, VAN NUYS, CA 91402-4432
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7112
PROVIDER NUMBER
CA
Enumeration date
04/26/2007
Last updated
07/08/2007
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us