Individual
JEANNINE JENAT JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7400 CENTER AVE APT 548, HUNTINGTON BEACH, CA 92647-9191
(301) 412-4019
Mailing address
7400 CENTER AVE APT 548, HUNTINGTON BEACH, CA 92647-9191
(301) 412-4019
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95036775
CA
Other
Enumeration date
09/18/2025
Last updated
09/18/2025
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