Individual
MR. LEE ALVIN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2311 W EL SEGUNDO BLVD, HAWTHORNE, CA 90250-3315
(310) 970-5000
Mailing address
2311 W EL SEGUNDO BLVD, HAWTHORNE, CA 90250-3315
(323) 241-6730
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
10/27/2006
Last updated
05/15/2025
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