Individual
JACKEY JETT WILSON II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1680 THE ALAMEDA STE D, SAN JOSE, CA 95126-2208
(650) 444-3189
Mailing address
1680 THE ALAMEDA STE D, SAN JOSE, CA 95126-2208
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
ASW105906
CA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
01/14/2009
Last updated
08/26/2025
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