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1104577147
ANGELIQUE ALLYSSA JACKSON
OCEANSIDE, CA
NPI
1104577147
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Former Name
ANGELIQUE ALLYSSA HAYS
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2022-01-11
Last Update Date
2022-01-11
Business Address
ANGELIQUE ALLYSSA JACKSON
2122 S EL CAMINO REAL STE 201
OCEANSIDE, CA 92054-6210
Phone number: 760-290-8170
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Mailing Address
ANGELIQUE ALLYSSA JACKSON
2122 S EL CAMINO REAL STE 201
OCEANSIDE, CA 92054-6210
Phone number: 760-290-8170
Copy
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