Individual
CHRISTINE DIANE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
1600 EUREKA RD, ROSEVILLE, CA 95661-3027
(916) 784-5078
Mailing address
1600 EUREKA RD, ROSEVILLE, CA 95661-3027
(916) 784-5078
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT4190
CA
Other
Enumeration date
12/12/2006
Last updated
12/30/2021
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