Individual
ANN C JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
333 S CENTRAL AVE, LOS ANGELES, CA 90013-1724
(213) 625-5009
Mailing address
27 N BONNIE AVE, PASADENA, CA 91106-2101
(626) 533-3862
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/11/2009
Last updated
04/28/2015
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