Individual
TONJA M JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
23213 LYNN ST, HAYWARD, CA 94541-7426
(510) 978-2361
Mailing address
23213 LYNN ST, HAYWARD, CA 94541-7426
(510) 978-2361
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
251B00000X
Case Management Agency
—
—
Other
Enumeration date
08/17/2020
Last updated
08/17/2020
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