Individual
CEDRIC JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
404 CAMINO DEL RIO S STE 102, SAN DIEGO, CA 92108-3586
(800) 316-6314
Mailing address
404 CAMINO DEL RIO S STE 102, SAN DIEGO, CA 92108-3586
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1208385
TX
Other
Enumeration date
06/02/2025
Last updated
09/08/2025
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