Individual
ALICIA M. JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6707 EMBARCADERO DR, STOCKTON, CA 95219-3382
(209) 956-4240
Mailing address
6707 EMBARCADERO DR, STOCKTON, CA 95219-3382
(209) 956-4240
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
05/28/2015
Last updated
08/01/2016
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