Individual
JESSICA MARIE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3125 MYERS ST BLDG 3, RIVERSIDE, CA 92503-5527
(951) 358-5862
Mailing address
3125 MYERS ST BLDG 3, RIVERSIDE, CA 92503-5527
(951) 358-5862
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/14/2023
Last updated
08/07/2024
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