Individual
MR. ALEXANDER ENACIO JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
7200 BANCROFT AVE, SUITE 125-D, ALAMEDA COUNTY BHCS, OAKLAND, CA 94605-2403
(510) 777-3877
(510) 777-3880
Mailing address
3701 PARK BOULEVARD WAY, OAKLAND, CA 94610-2837
(510) 530-0767
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCS19196
CA
Other
Enumeration date
07/20/2006
Last updated
04/28/2009
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