Individual
JOHN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4025 W 226TH ST, TORRANCE, CA 90505-2340
(310) 373-4556
Mailing address
4025 W 226TH ST, TORRANCE, CA 90505-2340
(310) 373-4556
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
225400000X
Rehabilitation Practitioner
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
CA
Other
Enumeration date
06/27/2023
Last updated
12/29/2025
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