Individual
MR. BRYAN EDWARD JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BRIENING
Contact information
Practice address
1001 POTRERO AVE, SAN FRANCISCO, CA 94110-3518
(415) 206-4288
(415) 206-6875
Mailing address
2223 LYNBROOK DR, PITTSBURG, CA 94565-5303
(925) 565-9348
(415) 206-6875
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
CA
Other
Enumeration date
01/16/2007
Last updated
07/08/2007
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