Individual
JONATHAN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6041 BRISTOL PKWY STE 100, CULVER CITY, CA 90230-6601
(661) 483-9222
Mailing address
6041 BRISTOL PKWY STE 100, CULVER CITY, CA 90230-6601
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
08/06/2024
Last updated
08/06/2024
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