Individual
GABRIELLE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2300 NORTHPOINT PKWY, SANTA ROSA, CA 95407-5004
(707) 571-5581
Mailing address
2300 NORTHPOINT PKWY, SANTA ROSA, CA 95407-5004
(707) 571-5581
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
Other
Enumeration date
04/05/2016
Last updated
02/22/2018
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