Individual
DALICIA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11757 NEHMENS WAY, ADELANTO, CA 92301-3795
(760) 987-4829
Mailing address
11757 NEHMENS WAY, ADELANTO, CA 92301-3795
(760) 987-4829
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
749471
CA
Other
Enumeration date
12/11/2025
Last updated
12/11/2025
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