Individual
BROOKE P JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1044 SIR FRANCIS DRAKE BLVD, SUITE 1, KENTFIELD, CA 94904-1449
(415) 609-2361
Mailing address
1044 SIR FRANCIS DRAKE BLVD, SUITE 1, KENTFIELD, CA 94904-1449
(415) 609-2361
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY 27339
CA
Other
Enumeration date
07/08/2008
Last updated
08/11/2015
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