Individual
DR. AJANI DECHAUN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1959 SOLANO WAY, CONCORD, CA 94520-5526
(925) 676-9768
Mailing address
PO BOX 4961, EL DORADO HILLS, CA 95762-0027
(404) 717-2168
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A131170
CA
390200000X
Student in an Organized Health Care Education/Training Program
150257
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
94-2209679
—
CA
Enumeration date
08/02/2009
Last updated
05/08/2026
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