Individual
DR. AMANDA SUE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
850 5TH ST, GONZALES, CA 93926-9491
(831) 675-3601
Mailing address
100 WILSON RD STE 100, MONTEREY, CA 93940-7885
(831) 242-8301
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
77092-20
WI
208000000X
Pediatrics Physician
Primary
A91439
CA
2080C0008X
Child Abuse Pediatrics Physician
77092-20
WI
Other
Enumeration date
08/05/2006
Last updated
01/14/2025
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